产前超声诊断胎儿法洛四联症体会  

Study of Echocardiography in the Prenatal Screening of Tetralogy of Fallot

作　　者：陈颖培 徐惠英[1] 

机构地区：[1]同济大学附属第一妇婴保健院超声科,上海200040

出　　处：《医学综述》2015年第10期1916-1918,共3页Medical Recapitulate

摘　　要：目的探讨超声心动图诊断胎儿法洛四联症的临床应用价值,提高法洛四联症的产前超声诊断正确率。方法回顾性分析2008年3月至2011年8月同济大学附属第一妇婴保健院收治的17例产前超声提示后经引产心脏解剖或产后超声证实为法洛四联症及误诊患儿的心脏超声声像图特征。结果产前超声诊断胎儿法洛四联症16例,其中12例产后尸检,法洛四联症11例,右心室双出口1例;4例经产后超声证实为法洛四联症。1例产前误诊为对位不良型室间隔缺损,产后超声诊断为法洛四联症。法洛四联症胎儿心脏基本特征:室间隔呈不同程度缺损,直径为(4.81±0.83)mm,主动脉骑跨(42±12)%,主动脉增宽,肺动脉狭窄,肺动脉内经与主动脉内经比值0.68±0.17;右心室形态无显著改变,右心室流出道与肺动脉前向流速增快不明显,仅3例超过1.0 m/s。结论综合左心室流出道长轴观测量主动脉骑跨率,肺动脉主干内径与主动脉内径比值,肺动脉内血流及动脉导管内血流情况以及二尖瓣与主动脉瓣的连接类型,可以提高法洛四联症的产前超声诊断的准确率。Objective To evaluate the diagnostic value of echocardiography in the prenatal screening of tetralogy of Fallot in order to improve the prenatal echocardiographic diagnostic rate of tetralogy of Fallot. Me thods Ehocardiographic features of 17 fetuses with abnormal hearts admitted in Shanghai First Maternity and Infant Hospital Affiliated to Tongji University from Mar.2008 to Aug.2011 were retrospectively ana-lyzed.Most of them were diagnosed as tetralogy of Fallot by prenatal echocardiography examination ormisdiag-nosed by heart autoptical pathology or postpartum ultrasonography.Results There were 16 cases diagnosed as tetralogy of Fallot by prenatal echocardiography,12 cases out of the 16 underwent postpartum autopsy,and 11 cases were confirmed as tetralogy of Fallot and 1 case as double-outlet right ventricle;4 cases out of the 16 were confirmed as tetralogy of Fallot by postpartum echocardiography.One case misdiagnosed as ventricular septal defect by prenatal examination was confirmed as tetralogy of Fallot by postpartum echocardiography . Fetus with tetralogy of Fallot has following basic heart characteristics：varying degrees of defects in interven-tricular septum of the heart with diameter of （4.81 ±0.83） mm;the aortic root,of necessity,overrode the muscular ventricular septum by （42 ±12）%;the aorta became wide and the pulmonary artery was narrow, the ratio between the inner diameters of pulmonary artery and aorta was 0.68 ±0.17;the right ventricular morphology had no significant change and the blood flow velocities in both right ventricular outflow tract and pulmonary artery did not increase much,only over 1.0 m/s in 3 cases.Conclusion Conventional observa-tion of the degrees of overriding of the aorta in the left ventricular outflow tract ,ratio between inner diameters of pulmonary artery and aorta,pulmonary and ductus arteriosus blood flow,as well as the connection type of anterior mitral valve and aortic posterior wall can improve the prenatal diagnostic accuracy in fetuses with tet-ralogy

关 键 词：法洛四联症 胎儿 超声心动图 

分 类 号：R714.53[医药卫生—妇产科学]