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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2022, Vol. 19 ›› Issue (01) : 71 -77. doi: 10.3877/cma.j.issn.1672-6448.2022.01.014

综述

胎儿冠状静脉窦扩张的原因分析与产前超声诊断
练敏1, 钟晓红1, 罗丹丹2, 李胜利2,†()   
  1. 1. 361000　厦门大学附属妇女儿童医院　厦门市妇幼保健院超声科
    2. 518028　南方医科大学附属深圳妇幼保健院超声科
  • 收稿日期:2020-10-10 出版日期:2022-01-01
  • 通信作者: 李胜利

Causes and prenatal ultrasound diagnosis of fetal dilated coronary sinus

Min Lian1, Xiaohong Zhong1, Dandan Luo2   

  • Received:2020-10-10 Published:2022-01-01
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练敏, 钟晓红, 罗丹丹, 李胜利. 胎儿冠状静脉窦扩张的原因分析与产前超声诊断[J]. 中华医学超声杂志（电子版）, 2022, 19(01): 71-77.

Min Lian, Xiaohong Zhong, Dandan Luo. Causes and prenatal ultrasound diagnosis of fetal dilated coronary sinus[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(01): 71-77.

图1 永存左上腔静脉合并冠状静脉窦扩张产前超声声像图。图a 四腔心切面可见冠状静脉窦扩张回声；图b 冠状静脉窦长轴切面可见扩张的冠状静脉窦汇入右心房（RA）内；图c 三血管气管切面显示肺动脉（PA）的左侧及主动脉（AO）的右侧分别存在左、右上腔静脉（LSVC、RSVC）；图d 左上腔静脉长轴切面实时超声显示其汇入冠状静脉窦（CS）内注：LV为左心室；LA为左心房；SP为脊柱；DAO为降主动脉
图2 完全性心内型肺静脉异位引流产前超声声像图。图a 左心房（LA）后壁光滑，无肺静脉汇入，左心房后方可见肺总静脉（CPV）回声，房间隔中部无卵圆孔回声；图b 二维超声显示左、右肺静脉（LPV、RPV）进入肺总静脉，继而进入冠状静脉窦，最后汇入右心房（RA）；图c 彩色多普勒示左、右肺静脉（LPV、RPV）进入肺总静脉，继而进入冠状静脉窦，最后汇入右心房（RA）注：RV为右心室；LV为左心室；ASD为房间隔缺损；DAO为降主动脉；SP为脊柱；CS为冠状静脉窦；L为左；R为右
图3 Ⅱ型无顶冠状静脉窦综合征合并扩张的冠状静脉窦伴有永存左上腔静脉产前超声声像图。图a 冠状静脉窦水平横切面显示冠状静脉窦明显扩张，冠状静脉窦与左心房间的间隔连续性回声中断；图b 三血管气管切面显示主动脉弓位于气管右侧，其两侧分别可见左、右上腔静脉回声注：LA为左心房；LV为左心室；RA为右心房；RV为右心室；CS为冠状静脉窦；UCS为无顶冠状静脉窦；SP为脊柱；LSVC为左上腔静脉；RSVC为右上腔静脉；RARCH为右位主动脉弓；T为气管；L为左；R为右
图4 静脉导管与冠状静脉窦（CS）异常连接时横切面及旁矢状切面可显示静脉导管（DV）未汇入下腔静脉（IVC），而直接连于冠状静脉窦入右心房（RA，箭头所示）注：ST为胃泡
图5 查找冠状静脉窦扩张病因的诊断思路图
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