超声不同切面在诊断胎儿室间隔缺损中的价值评价  

Evaluation of Different Views in the Diagnosis of Fetal Ventricular Septal Defect by Echocardiography

作　　者：张颖[1] 蔡爱露[1] 姜克新[1] 韩冰[1] 赵一理[1] 李婷[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,沈阳市110004

出　　处：《中国超声医学杂志》2009年第7期697-699,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家科技支撑计划（No.2006BA105A04）

摘　　要：目的探讨超声不同切面在诊断胎儿室间隔缺损中的意义以期提高超声对胎儿室间隔缺损的检出率。 方法对62例胎儿室间隔缺损的超声资料进行分析。对受检胎儿进行胃泡水平横切面、心尖四腔心切面、心尖五腔心切面、右室流出道长轴切面及主动脉根部短轴切面扫查，观察室间隔缺损的位置及大小。 结果产前超声正确诊断60例，漏诊2例。其中四腔心对称的占87．1％。五腔心切面对室间隔缺损的检出率明显高于四腔心切面，联合应用四腔心、五腔心及有室流出道切面不但对室间隔缺损的检出率显著提高，还可明显提高对大动脉水平畸形的检出率。对于室上嵴下型缺损的诊断，心尖五腔心切面优于心尖四腔心切面；右室流出道长轴切面是诊断室上嵴上型缺损最佳检杏切面。 结论单纯应用四腔心切面在诊断胎儿室间隔缺损上有局限性，联合应用四腔心切面、五腔心切面和右室流出道长轴切面町显著提高对各型室间隔缺损的检出率，并且在诊断室间隔缺损合并的大动脉水平的畸形上有重要意义。Objective To evaluate the importance of different views in the prenatal diagnosis of fetal ventricular septal defect （VSD） . Methods The data of 62 fetuses diagnosed as VSD were reviewed. In the process of fetal echo cardiography, trans-magenblase view, four chamber view, five chamber view, right ventricular outflow tract view and aortic short axis view were used to observe the size and location of the defect. Results 60 cases were correctly diagnosed while two cases were miss diagnosed. Symmetrical four chamber view were observed in 87. 1% of all the cases. Five chamber view is better than four chamber view in diagnosing VSD. By using combined sections （apical four chamber view, apical five chamber view and right ventrieular outflow tract view） , not only the detection rate of VSD but also the detection rate of abnormities at the great artery level are higher than the way only use four chamber view. Apical five chamber view is better than apical four chamber view in diagnosing infra-cristal ventricular septal defect and right ventricular outflow tract view is the best section to detect supracristal ventricular septal defect. Conclusions Using combined sections of apical four chamber view, apical five chamber view and right ventricular outflow tract view is not only a better way to diagnosis VSD but also to diagnosis the incorporated abnormities at the great artery level than only use four chamber view.

关 键 词：产前诊断 胎儿心脏 室间隔缺损 超声心动描记术 四腔心切面 

分 类 号：R714.53[医药卫生—妇产科学] R765.7[医药卫生—临床医学]