Echocardioimagedata characteristics of fetal isolated total anomalous pulmonary venous connection and application of high definition flow imaging and spatio-temporal image correlation

doi:10.3877/cma.j.issn.1672-6448.2023.10.010

Abstract

Abstract:

Objective

To analyze the two-dimensional gray scale and color Doppler echocardiography characteristics of fetal isolated complete pulmonary venous drainage (TAPVC) , and to explore the application of four-dimensional time-space correlation imaging (STIC) and high definition flow imaging (HD-flow) in the prenatal diagnosis of isolated TAPVC.

Methods

A retrospective analysis was performed on 16 cases of fetal isolated TAPVC at Guangxi in Maternity & Child Healthcare Hospital. Nine cases were diagnosed by two-dimensional gray scale and color Doppler echocardiography from January 2016 to January 2018, and seven cases were diagnosed based on two-dimensional echocardiography and four-dimensional STIC and HD-flow from February 2018 to March 2021. All of the above cases were both diagnosed by direct and indirect ultrasonography signs, and all cases were followed up.

Results

The study included supracardiac type TAPVC in 12 (12/16) cases, cardiac type in 2 (2/16), and infracardiac type in 2 (2/16). Eight cases were found with direct ultrasound signs. Eight cases were found with indirect signs, including coronary sinus dilation in 2 cases, vertical vein or superior vena cava widening in 5, and abnormal blood vessels in the hilar area of the liver in 1.The four-dimensional STIC/HD-flow reconstruction images of 7 cases all showed that the 4 pulmonary veins were connected to the common pulmonary vein and joined into the systemic vein through vertical veins or the coronary sinus (right atrium).

Conclusions

The combination of direct and indirect signs of prenatal two-dimensional gray scale and color Doppler echocardiography is more helpful for the diagnosis of isolated fetal TAPVC, and four-dimensional STIC/HD-flow can provide more valuable information.

Key words: Total anomalous pulmonary venous connection, Echocardiography, Fetus, Prenatal diagnosis, Spatio-temporal image correlation, High definition flow imaging

Shuihua Yang, Guidan He, Guican Qin, Mengfeng Liang, Yanhe Luo, Xueqin Li, Juansong Tang. Echocardioimagedata characteristics of fetal isolated total anomalous pulmonary venous connection and application of high definition flow imaging and spatio-temporal image correlation[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1061-1067.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2023.10.010

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Figures/Tables 5

References 26

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病例	年龄（岁）	孕龄（周）	类型	首要超声切面^a	首要超声线索^b	四维重建	垂直静脉梗阻	随访结局
1	25	30	心上型	四腔心切面	肺静脉未与左心房相连	否	否	术后存活
2	27	23	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	否	否	终止妊娠
3	24	23	心上型	四腔心切面	肺静脉未与左心房相连	否	否	术后死亡
4	28	21	心内型	冠状静脉窦切面	冠状静脉窦扩张	否	否	终止妊娠
5	33	22	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	否	是	新生儿期死亡
6	31	29	心上型	四腔心切面	肺静脉未与左心房相连	否	否	术后存活
7	35	24	心上型	四腔心切面	肺静脉未与左心房相连	否	否	终止妊娠
8	35	26	心下型	四腔心切面	肺静脉未与左心房相连	否	是	失访
9	32	23	心上型	四腔心切面	肺静脉未与左心房相连	否	否	终止妊娠
10	28	24	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	是	否	术后存活
11	33	28	心下型	腹部横切面	肝门脉区域异常血流	是	是	病理确诊
12	34	28	心上型	四腔心切面	肺静脉未与左心房相连	是	否	术后存活
13	31	24	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	是	否	终止妊娠
14	30	24	心内型	冠状静脉窦切面	冠状静脉窦扩张	是	否	术后存活
15	28	23	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	是	否	新生儿期死亡
16	29	25	心上型	四腔心切面	肺静脉未与左心房相连	是	是	术后死亡

病例	年龄（岁）	孕龄（周）	类型	首要超声切面^a	首要超声线索^b	四维重建	垂直静脉梗阻	随访结局
1	25	30	心上型	四腔心切面	肺静脉未与左心房相连	否	否	术后存活
2	27	23	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	否	否	终止妊娠
3	24	23	心上型	四腔心切面	肺静脉未与左心房相连	否	否	术后死亡
4	28	21	心内型	冠状静脉窦切面	冠状静脉窦扩张	否	否	终止妊娠
5	33	22	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	否	是	新生儿期死亡
6	31	29	心上型	四腔心切面	肺静脉未与左心房相连	否	否	术后存活
7	35	24	心上型	四腔心切面	肺静脉未与左心房相连	否	否	终止妊娠
8	35	26	心下型	四腔心切面	肺静脉未与左心房相连	否	是	失访
9	32	23	心上型	四腔心切面	肺静脉未与左心房相连	否	否	终止妊娠
10	28	24	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	是	否	术后存活
11	33	28	心下型	腹部横切面	肝门脉区域异常血流	是	是	病理确诊
12	34	28	心上型	四腔心切面	肺静脉未与左心房相连	是	否	术后存活
13	31	24	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	是	否	终止妊娠
14	30	24	心内型	冠状静脉窦切面	冠状静脉窦扩张	是	否	术后存活
15	28	23	心上型	三血管气管切面	上腔静脉增宽、出现垂直静脉	是	否	新生儿期死亡
16	29	25	心上型	四腔心切面	肺静脉未与左心房相连	是	是	术后死亡

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