多普勒超声心动图宫内诊断胎儿心脏肿瘤合并胎儿充血性心衰的临床意义  

Clinical significance of Doppler echocardiography in diagnosing fetal cardiac tumors and congestive heart failure

作　　者：陈红亮 段佳庆 赵苏云 段晓莉 续庆艳 CHEN Hong-liang;DUAN Jia-qing;ZHAO Su-yun;DUAN Xiao-li;XU Qing-yan(Department of Ultrasound Examination and Diagnosis,Shaanxi Provincial Health Institute of Ordnance Industry,Xian 710065,China)

机构地区：[1]陕西省兵器工业卫生研究所超声诊断科,西安710065

出　　处：《中国肿瘤临床与康复》2022年第10期1196-1198,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨多普勒超声心动图宫内诊断胎儿心脏肿瘤合并胎儿充血性心衰(CHF)的临床价值。方法选取2021年6月至2021年9月兵器工业卫生研究所检测的孕妇,使用胎儿超声心动图顺序分段法检测胎儿心脏肿瘤,并评价其血流动力学改变情况。结果共发现12例心脏肿瘤胎儿,心脏肥厚扩大7例,胎儿水肿2例。病理变化大都一致,主要为心胸面积比增大,心房、心室不对称性变大及心肌肥厚,左室短轴缩短率(FS)及心输出量(CCO)改变与正常组比较,差异有统计学意义(P<0.05)。其中,中至重度二、三尖瓣反流(MR、TR)8例,肺动脉瓣反流3例;脐静脉搏动性血流2例,腔静脉内径增宽及血流频谱改变。结论多普勒超声心动图可清晰显示胎儿心脏肿瘤,并且评价与CHF的相关因素。临床通过CCO可以无创获得心输出量及计算FS,量化胎儿心功能,并且准确评估心内及外周血流动力学变化。Objective To study the clinical value of Doppler echocardiography in diagnosing fetal cardiac tumors and congestive heart failure(CHF).Methods Fetuses were selected at Health Institute of Ordnance Industry from June 2021 to September 2021.Doppler echocardiography was used to detect fetal cardiac tumors and to evaluate their hemodynamic changes.Results Cardiac tumors were detected in 12 fetuses,of which 7 fetuses had cardiac hypertrophy and enlargement,and 2 fetuses had fetal hydrops.They mainly manifested as increased cardiothoracic area ratio,asymmetric enlargement of atrium and ventricle with comparable changes in pathological results.Different changes were observed in myocardial hypertrophy and fractional shortening(FS)in left ventricular diameter and cardiac output(CCO)compared with the normal controls(all P<0.05).Of them,8 fetuses had moderate to severe bicuspid or tricuspid regurgitation(MR and TR),3 fetuses had pulmonary regurgitation,and 2 fetuses had umbilical vein pulsatile blood flow,widening of vena cava diameter and changes in blood flow spectrum.ConclusionDoppler echocardiography can clearly display fetal cardiac tumors and evaluate the factors associated with CHF.Clinically,the sum of aortic and pulmonary arterial CO can be used to non-invasively obtain the index of cardiac output and calculate the FS to quantify fetal cardiac function,and to accurately assess intracardiac and peripheral hemodynamic changes.

关 键 词：胎儿心脏肿瘤 胎儿充血性心衰 多普勒超声 临床意义 

分 类 号：R732.1[医药卫生—肿瘤]