永存左侧上腔静脉的产前超声诊断及畸形分析  

Prenatal diagnosis of persistent left superior vena cava and its anatomic features

作　　者：丛娟[1] 程国梅[2] 吴娟[1] 

机构地区：[1]郑州大学第三附属医院超声科,郑州450052 [2]郑州大学第三附属医院产前诊断中心,郑州450052

出　　处：《郑州大学学报（医学版）》2013年第6期776-780,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省卫生科技创新型人才工程专项基金资助项目 豫卫科2010-52

摘　　要：目的:分析胎儿永存左侧上腔静脉(PLSVC)的影像特征及其伴随心内、心外畸形的特点。方法:回顾分析25 737例胎儿系统超声及超声心动图影像资料。三血管切面发现"第四条血管"时,进一步获得其长轴切面以明确诊断。结果:产前超声诊断胎儿PLSVC 67例,表现为肺动脉左侧的"第四条血管",长轴切面显示该血管血流经冠状静脉窦流入心房。PLSVC胎儿与非PLSVC胎儿的心内结构异常发生率比较,差异有统计学意义(χ2校正=955.968,P<0.001),且2组胎儿的静脉异常发生率比较,差异有统计学意义(P<0.001)。心脏畸形胎儿中,PLSVC胎儿与非PLSVC胎儿的心房异构发生率比较,差异有统计学意义(χ2校正=84.223,P<0.001)。在PLSVC合并心脏畸形胎儿中,心房异构者心脏畸形以房室间隔缺损、右室双出口为多;非心房异构者心脏畸形以室间隔缺损、圆锥动脉干畸形及主动脉弓缩窄为多。结论:三血管及腔静脉长轴切面是诊断PLSVC的最佳切面。PLSVC胎儿易合并心脏畸形,特别是心房异构综合征及血管发育异常。Aim：To analyze sonographic features of persistent left superior vena cava（ PLSVC） of fetuses and its cardiac and extracardiac anomalies. Methods：A total of 25 737 sonographic and echocardiographic data of fetuses were retrospectively studied. When a supernumerary vessel left of the pulmonary trunk showed on three-vessel view,it would be scaned on long-axis view. Results：A total of 67 cases of PLSVC were detected,which was showed as an additional vessel identified to the left pulmonary artery on three-vessel view and drainage via the coronary sinus into atrium on long-axis view.The congenital heart defect rates were significantly different between fetuses with and without PLSVC（ χ2adjust= 955. 968,P 0. 001） and the anomalous connection of vein rates were also significantly different（ P 0. 001）. Between fetuses with and without PLSVC the atrial isomerism rates were also different（ χ2adjust= 84. 223,P 0. 001）. Among fetuses with PLSVC,the most common cardiac malformations in those with atrial isomerism were atrioventricular septal defect and double right ventricle outlets,while the common most congenital heart defects in those without atrial isomerism were ventricular septal defect,conotruncal defect and coarction. Conclusion：The three-vessel view and long-axis vein view are the best diagnostic planes of PLSVC. PLSVC has greater prevalence in fetuses with congenital heart defects,especially with atrial isomerism and venous anomaly cases.

关 键 词：永存左侧上腔静脉 心脏畸形 心房异构 产前诊断 

分 类 号：R543.2[医药卫生—心血管疾病] R445.1[医药卫生—内科学]