胎儿肺动脉闭锁伴室间隔缺损的超声诊断  

Ultrasonic Diagnosis of Fetal Pulmonary Atresia with Ventricular Septal Defect

作　　者：于金华[1] 高文娟[1] 黄进[1] 付世文[1] 缪伟[1] 王军华[1] 杨凤霞[1] 代培凤[1] 

机构地区：[1]潍坊市人民医院超声科,山东潍坊261041

出　　处：《辽宁医学院学报》2016年第2期18-20,I0004,共4页Journal of Liaoning Medical University (LNMU) Bimonthly

基　　金：山东省医药卫生科技发展计划面上项目;项目编号:2013WS0044

摘　　要：目的探讨产前超声诊断胎儿肺动脉闭锁伴室间隔缺损的临床价值。方法回顾分析15例经解剖证实的肺动脉闭锁伴室间隔缺损的超声心动图资料并总结声像图特征。结果 15例PA-VSD均显示室间隔缺损及增宽的主动脉骑跨于室间隔上,骑跨率达40%以上;9例主肺动脉显示且内径窄于主动脉内径,6例主肺动脉不显示;左右肺动脉均有融合,分支发育尚可6例,9例左右肺动脉分支发育欠佳。四腔心对称12例,3例因合并心内畸形四腔心切面不对称;三血管及气管切面均显示有异常;彩色多普勒血流显像15例PA-VSD动脉导管探及反向血流信号。结论产前超声心动图可以诊断肺动脉闭锁伴室间隔缺损,并能够观察肺动脉主干及其分支的发育情况,评估肺动脉的发育情况,为选择性优生及生后手术提供重要的临床信息。Objective To explore the clinical value of prenatal ultrasound for diagnosis of fetal pulmonary atresia with ventricular septal defect（ PA- VSD）. Methods Echocardiography data of 15 fetuses with pulmonary atresia along with ventricular septal defect（ PA- VSD） confirmed by autopsy were analyzed retrospectively,and the characteristics of their abnormal ultrasound images were summarized. Result 15 cases of PA- VSD all showed ventricular septal defect and broadening of aorta straddling on ventricular septal,in which the straddles rate was about 40%. Diameters of primary pulmonary artery of 9 cases were smaller than those of aorta. Primary pulmonary artery of 6 cases didn＇ t show. Left and right pulmonary arteries were fused. 6 branches developed well,while 9branches of left and right pulmonary artery developed poorly. Four- chamber view of 12 cases with PA- VSD was symmetrical,while that of 3 cases was asymmetrical because of cardiac malformations. Three blood vessels and trachea view were abnormal. Reverse flow of arterial duct of all cases with PA- VSD were detected by Color Doppler flow imaging. Conclusion Pulmonary atresia with ventricular septal defect can be diagnosed accurately by prenatal echocardiography. Development of pulmonary artery trunk and its branches can be observed to assess development of pulmonary artery,which is helpful to provide important clinical information for selective termination of pregnancy and postpartum surgery of fetuses.

关 键 词：心脏疾病 先天性 超声心动描记术 产前 肺动脉闭锁 

分 类 号：R445.1[医药卫生—影像医学与核医学]