胎儿右室双出口的超声诊断、分型与预后  

Diagnosis, classification and prognosis prediction of fetal double outlets of right ventricle by echocardiography

作　　者：李军[1] 朱霆[1] 朱永胜[1] 孙益前[1] 徐鹏[1] 王铮[1] 张建芳[2] 苏海砾[1] 庞珅[1] 

机构地区：[1]第四军医大学西京医院超声科陕西省胎儿先天性心脏病超声诊断中心,西安710032 [2]第四军医大学西京医院产科实验室,西安710032

出　　处：《中华超声影像学杂志》2013年第12期1027-1030,共4页Chinese Journal of Ultrasonography

基　　金：陕西省科技统筹创新工程计划项目（2012KTCL03-09）;陕西省科学技术研究发展计划项目（2010K5-06-03）;陕西省科学技术研究发展计划项目（2012SF2-14-3）

摘　　要：目的探讨胎儿右室双出口（double outlet of rightventricle，DORV）的超声诊断、病理解剖分型和预后。方法采用系统多切面胎儿超声心动图检查方法，分析经我院筛查并确诊的59例胎儿DORV的超声表现特点、病理解剖分型与合并畸形。结果59例DORV中56例心房与心室连接一致；主动脉右转位44例，左转位7例，大血管关系正常2例，早期未分类6例；53例DORV中SDD型最常见，约占81％（43／53）；合并畸形包括肺动脉口狭窄21例，单心房5例，房室瓣狭窄3例，升主动脉发育较细2例。羊水穿刺染色体检查7例，其中5例染色体正常，21-三体及18-三体各1例。结论胎儿超声心动图能够准确诊断胎儿DORV，判断其分型，检测合并畸形，详细的检查能够评估出生后的手术方式和预后。Objective To study the accuracy of diagnosis, anatomical classification and prognostic prediction of double outlet of right ventricle （DORV） by fetal echocardiography. Methods Fifty-nine fetuses detected and diagnosed with DORV by fetal echocardiography were investigated to analyze the anatomical characteristics, types and complicated malformations. Results Fifty-nine fetuses with DORV included 56 with atrioventricular accordance and 3 with atrioventricular discordance. Among them, there were 44 with dextro-transposition of great arteries,7 with levo-transposition,2 with normal position,6 with un-identified in early stage. SDD was the most common type in DORV for approximate 81% （44/53）. Complicated abnormalities included pulmonary artery stenosis in 21 fetuses, single atrium in 5, atrial- ventricular valvular stenosis in 3,and mild ascending aortic dysplasia in 2. Amniocentesis and chromosome were test in 7 fetuses including 5 fetuses with normal chromosomes, one with trisomy 21 and one with trisomy 18. Conclusions Fetal echocardiography shows high clinical value in diagnosis, classification and detecting complicated abnormalities of DORV. Careful examinations provide accurate evaluation in surgical procedure and prognosis.

关 键 词：超声检查 产前 右室双出口 

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]