早孕期胎儿静脉导管异常的超声表现及预后分析  

Ultrasonic manifestations and prognosis analysis of fetal ductus venous abormalities in early pregnancy

作　　者：白艳[1] 石涛[1] 赵婧[1] 何冠南[1] 蒋琴[1] 杨家翔[1] BAI Yan;SHI Tao;ZHAO Jing;HE Guannan;JIANG Qin;YANG Jiaxiang(Department of Ultrasound,Sichuan Maternal and Child Health Hospital,Chengdu 610041,China)

机构地区：[1]四川省妇幼保健院超声科,成都市610041

出　　处：《临床超声医学杂志》2021年第6期464-467,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨早孕期胎儿静脉导管异常的超声表现及预后情况。方法回顾性分析我院早孕期经超声检出的26例胎儿静脉导管异常的超声图像,记录静脉导管结构、走行及脐静脉连接情况,追踪随访其预后。结果26例胎儿均为静脉导管缺如,其中16例脐静脉汇入门静脉,4例脐静脉汇入下腔静脉,2例脐静脉汇入右房,1例脐静脉汇入左房,3例门-肝静脉分流。静脉导管缺如表现为上腹部各切面均未见静脉导管入膈下前庭,正常的脐静脉-左门静脉-静脉导管-下腔静脉之间的序贯连接关系消失,脐静脉绕过肝脏形成脐静脉肝外异位连接或肝内分流。7例合并心内外结构异常,8例合并心外结构异常,2例合并心内结构异常,9例未合并其他结构异常。染色体检查显示,16例染色体正常,1例18-三体,1例21-三体,6例未行染色体检查,2例失访。14例引产,9例出生后暂未见明显异常,1例出生后行室间隔缺损修补术后生长发育缓慢,2例失访。结论早孕期胎儿静脉导管异常的超声表现主要为静脉导管缺如,具有一定特征性;其预后情况主要取决于胎儿是否合并心内外畸形及染色体异常。Objective To explore the ultrasonic manifestations and prognosis of fetal ductus venosus abnormalities in early pregnancy.Methods The ultrasonic images of 26 fetuses with ductus venosus abnormalities diagnosed by ultrasonography during early pregnancy in our hospital were retrospectively analyzed.Ductus venosus structure,umbilical vein connection,and fetal outcomes were recorded.Results Twenty-six cases were found with absence of ductus venosus,including 16 cases of umbilical vein connected to the portal vein,4 cases of umbilical vein connected to the inferior vena cava,2 cases of umbilical vein connected to the right atrium,1 case of umbilical vein connected to the left atrium,3 cases of portal-hepatic vein shunt.The absence of ductus venosus showed that there was no ductus venosus entering the inferior phrenic vestibule in each section of the upper abdomen,the sequential connection of the umbilical vein-left portal vein-ductus venosus-inferior vena cava disappeared,and the umbilical vein bypassed the liver to form extrahepatic ectopic connection or intrahepatic shunt.7 cases had intracardiac and extracardiac abnormalities,8 cases had extracardiac abnormalities,2 cases had intracardiac abnormalities,9 cases had no other structural abnormalities.There was 1 case of 18 trisomy syndrome,1 case of 21 trisomy syndrome,6 cases were not undernent chromosomal examination,and 2 cases were lost to follow-up.14 cases of induced labor,and 9 cases showed no abnormality after birth,1 case underwent repair of ventricular septal defect after birth,the growth and development was slow after operation,and 2 cases were lost to follow-up.Conclusion The main ultrasonic manifestations of fetal ductus venous abormalities in early pregnancy is absence of ductus venous,and its prognosis mainly depends on whether the fetus has intra-or extra-cardiac malformations and chromosomal abnormalities.

关 键 词：超声检查 早孕期 胎儿 静脉导管异常 

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]