大动脉转位的产前超声诊断  

Prenatal diagnosis of transposition of the great arteries with fetal echocardiography

作　　者：吕国荣[1] 胡诗音[1] 李丽雅[1] 李伯义[1] 何韶铮[1] 徐晚虹[1] 

机构地区：[1]福建医科大学附属第二医院超声科,福建泉州362000

出　　处：《中国医学影像技术》2009年第4期668-670,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的分析大动脉转位(TGA)的产前超声图特征。方法回顾性分析产前超声筛查的11例TGA胎儿在四腔心断面、左、右心室流出道断面、三血管和三血管气管断面的声像图特征。全部病例均经产后超声心动图或尸检证实。结果①11例TGA中(单纯性完全型TGA6例,复合性TGA4例,矫正型TGA1例)除1例漏诊外,其余10例均被产前超声心动图检出;②在左心室和(或)右心室流出道断面上,能显示主动脉和肺动脉呈平行走向(10例),主动脉发自形态学的右心室(8例),肺动脉发自形态学的左心室(9例);③在四腔心断面上,单纯性完全型和矫正型TGA都表现为四腔心对称,而复合性完全型TGA皆表现为四腔心不对称;④在三血管断面上,TGA胎儿降主动脉比肺动脉更靠前胸壁(7例),在三血管气管断面上,8例TGA胎儿的超声心动图皆显示两条血管而非三条血管(主动脉弓和上腔静脉)。结论心脏基础加强等级心脏扫查各个断面能显示TGA的声像图特点,有助于TGA的产前诊断。Objective To analyze the sonographic features of transposition of the great arteries （TGA）. Methods Sonographic features of 11 fetuses in the four-chamber view, left and right ventricular outflow tract views, three-vessel （3V） view, three vessels and trachea （3VT） view were retrospectively analyzed. All the cases were confirmed by postnatal echocardiography or autopsy. Results ①All of the 11 cases of TGA （6 of isolated complete TGA, 4 of complicated complete TGA and 1 of corrected TGA） were diagnosed by prenatal echocardiography except one. ②In left or right ventricle outflow tract views, all of the cases presented a parallel distribution of aorta and pulmonary artery, 8 of whom had aorta arising from the morphological right ventricular, and 9 had pulmonary artery arising from the morphological left ventricular. ③In the four-chamber view, symmetrical four-chamber heart was seen in isolated complete TGA and corrected TGA, while asymmetrical four-chamber heart appeared in complicated complete TGA. ④In the 3V view, the ascending aorta was closer to anterior chest than the pulmonary artery in 7 cases. In the 3VT view, the two vessels of aortic arch and superior vena cava rather than three displayed in 8 of TGA fetuses. Conclusion Cardiac scan with extended basic level by fetal echocardiography can be used to exhibit sonographic features of TGA, and contributes to the prenatal diagnosis of TGA.

关 键 词：大动脉转位胎儿 超声心动描记术 产前 

分 类 号：R540.45[医药卫生—心血管疾病] R714.5[医药卫生—内科学]