室间隔完整型肺动脉闭锁的产前超声诊断价值分析  

Diagnostic value of pulmonary atresia with intact ventricular septum by prenatal echocardiography

作　　者：杨萍[1] 葛群[1] 张玉奇[2] 王凤蕾[1] 张志芳[2] 江丽[1] 

机构地区：[1]安徽省马鞍山市妇幼保健院超声科,安徽马鞍山243000 [2]上海交通大学医学院附属上海儿童医学中心心内科,上海200127

出　　处：《医学影像学杂志》2014年第11期1899-1902,共4页Journal of Medical Imaging

基　　金：上海市科学技术委员会资助项目(项目编号:10DZ1951200)

摘　　要：目的评价超声心动图对室间隔完整型肺动脉闭锁伴(PA/IVS)的产前诊断价值,分析超声心动图误诊的原因,旨在提高超声心动图对胎儿PA/IVS诊断的正确性。方法回顾性分析19例经胎儿核磁共振(MRI)或出生后超声心动图诊断为PA/IVS的产前超声资料。结果 PA/IVS最常见的超声征象为三尖瓣反流19例(100%)、动脉导管内逆向血流18例(94.7%)及右心室肥厚伴心腔小13例(68.4%)。19例PA/IVS胎儿超声心动图诊断正确16例,占84.2%;漏、误诊3例,占15.8%;误诊2例,其中1例产前超声心动图误诊为肺动脉瓣重度狭窄、三尖瓣重度反流,1例产前误诊为三尖瓣轻度反流;1例生后超声检查显示右心室内心肌窦样间隙开放。结论联合应用四腔心切面、心室流出道切面及三血管切面,超声心动图可以比较准确地诊断胎儿PA/IVS,但需要与重度肺动脉瓣狭窄鉴别。Objective To evaluate the diagnostic value of prenatal echocardiography in pulmonary atresia with intact ven‐tricular septum （PA/IVS） ,to analyze the reasons of misdiagnosed and to improve the echocardiographic diagnosis .Meth‐ods A retrospective echocardiographic review was performed on 19 fetus with PA/IVS confirmed by prenatal magnetic resonance imaging （MRI） or postnatal echocardiography .Results More common findings of PA/IVS were tricuspid valve regurgitation in 19 cases （100% ） ,reversed flow through ductus arteriosus by color Doppler flow imaging in 18 cases （94.7% ） ,and right ventricular hypoplasia in 13 cases（68 .4% ） .Among 19 PA/IVS fetus ,16 cases （84 .2% ） were diag‐nosed correctly by echocardiography .In the remaining 3 cases （15 .8% ） ,1 case with pulmonary valve stenosis ,tricuspid valve regurgitation and right ventricular hypoplasia and 1 case with mild tricuspid valve regurgitation were diagnosed by prenatal echocardiography ,1 case with intramyocardial sinusoids was misdiagnosed .Conclusion Combining visualization of PA/IVS in four‐chamber view ,outflow tract view ,and three vessels view ,PA/IVS could be accurately diagnosed by prenatal echocardiography ,but it should be differentiated from critical pulmonary valve stenosis .

关 键 词：超声心动图 胎儿 肺动脉闭锁 室间隔完整 

分 类 号：R543.2[医药卫生—心血管疾病] R540.4[医药卫生—内科学]