产前超声心动图诊断胎儿心室室壁瘤:附二例回顾性分析  

Prenatal diagnosis of ventricular aneurysm by echocardiography:an analysis of two cases and a review

作　　者：王鸿[1] 耿丹明[1] 张艳萍[1] 王玉新[1] 熊华强[1] 

机构地区：[1]南京军区福州总医院超声科,福州350025

出　　处：《中华医学超声杂志（电子版）》2010年第7期60-62,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：福建省科技重点课题基金资助(2005I014);南京军区面上课题2007(07M092)

摘　　要：目的应用产前多普勒超声心动图诊断胎儿心脏室壁瘤并探讨其病因学。方法对2例产前经超声心动图确诊的胎儿室壁瘤图像进行回顾性分析。二维超声心脏切面有四腔心、五腔心、大血管交叉等并计算心胸比例,测量室壁瘤瘤壁厚度、动度;彩色多普勒显示左、右房室瓣血流及室壁瘤血流充盈形式;心功能评价有左室缩短分数(FS)及胎儿外周血流动力学指标。结果 2例均为右心室室壁瘤,发生部位在右心室近三尖瓣环的后方呈形态向外膨出的结构改变,2例大小分别是13.1mm×11.0mm和18.1mm×10.1mm,壁薄度为1.5mm、1.6mm。膨出部分的室壁运动幅度减低,例1胎儿FS轻度降低。结论产前超声心动图可检出和诊断胎儿室壁瘤,分析其病因多与冠状动脉病变和血栓形成有关,同时有可能是心肌梗死的结果。Objective To diagnose fetal ventricular aneurysm by prenatal Doppler echocardiography and reveal the relative aetiological factors. Methods Two cases of fetal ventricular aneurysm confirmed by prenatal Doppler echocardiography were analyzed. All dates were required in four or five chamber cardiac view and the cross of great vessels view by measuring the thickness and motion amplitude of the ventficular aneurysm. The left or right atrioventrieular valves flow and abnormal flow of ventricular aneurysm by color Doppler technology were recorded. The fetal cardiac ventrieular function by FS and peripheral vessels hemodynamics were assessed. Results Two eases were found to have right ventricular aneurysm behind the tricuspid valve annulus,morphology protruding, the size and wall thickness were 13.1 mm × 11.0 mm/18.1 mm × 10.1 mm, and 1.5 mm/1.6 mm, respectively; the motion of the bulging showed hypokinetie. A slight decrease was observed in the FS of one fetal. Conclusions Fetal ventrieular aneurysm could be discovered and diagnosed by prenatal echoeardiography, which may be led by coronary thromboembolism and myocardial infarction.

关 键 词：产前超声检查 心脏室壁瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]