胎儿左心发育不良综合征的产前超声诊断价值  

Diagnostic value of prenatal ultrasound of hypoplastic left heart syndrome

作　　者：陈艳[1] 刘敏[1] 何甦晖[1] 吴秋梅[1] 翁宗杰[1] 

机构地区：[1]福建省妇幼保健院福建医科大学教学医院超声科,福州350001

出　　处：《福建医药杂志》2015年第3期97-99,F0003,共4页Fujian Medical Journal

基　　金：福建省科技计划重点项目(2012Y0011)

摘　　要：目的探讨胎儿左心发育不良综合征(HLHS)的产前超声诊断价值,以提高对左心发育不良综合征的认识。方法回顾性分析经引产后尸解证实的10例HLHS胎儿的产前超声影像资料,对其超声特点进行分析。结果 10例胎儿中,8例产前超声诊断为HLHS,2例产前超声误诊:1例误诊为单心房、单心室、心室双出口、主动脉重度缩窄;另1例误诊为单心房、单心室、主动脉瓣严重狭窄、升主动脉及主动脉弓发育不良。产前超声诊断的8例HLHS胎儿的主要声像图特点为:四腔心不对称,右心明显增大,左心发育不良,二尖瓣狭窄或闭锁,主动脉瓣狭窄或闭锁,升主动脉逆向灌注血流。误诊的2例胎儿的尸解结果均为重度HLHS,即二尖瓣及主动脉瓣闭锁、左心室重度发育不良。结论产前超声对检出胎儿HLHS具有重要价值,但是重度HLHS易与单心房、单心室混淆,需注意二者间的鉴别诊断,避免误诊。Objective To study the diagnostic value of prenatal ultrasound of hypoplastic left heart syndrome （HLHS）, in order to improve the knowledge of HLHS. Methods We made a retrospective analysis of ten fetuses with HLHS that was confirmed by autopsy, and summarized the ultrasonic features of HLHS. Results In ten cases of fetuses, eight cases were cor- rectly diagnosed of HLHS, two cases were misdiagnosed by prenatal ultrasound, of which one was misdiagnosed of single atri- um, single ventricle, double outlet of ventricle, serious coarctation of the aorta, the other one was misdiagnosed of single atri- um, single ventricle, serious aortic stenosis, hypoplasia of the ascending aorta and the aorta. The major ultrasonic findings of eight cases with HLHS were disproportion of left and right heart, small developed left heart and enlarged right heart in four chamber view, stenosis or atresia of mitral valve and aortic valve, reverse blood streem of the ascending aorta. The autopsy re- sults of the two misdiagnosed cases were both serious HLHS, which had atresia of aortic and mitral valve, serious dysplasia of left heart. Conclusion Prenatal ultrasound is of great value to the detection of fetal HLHS. Serious HLHS may be easily con- fused with single atrium, single ventricle. So more attention should be paid to the differential diagnosis to avoid misdiagnosis.

关 键 词：左心发育不良综合征 胎儿 心脏 产前超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]