晚孕期胎儿房间隔膨胀瘤致左右心比例不对称的超声表现及预后分析  

Prenatal Echocardiographic Features of Fetal Atrial Septal Aneurysm with Ventricular Size Disproportion in the Third Trimester Pregnancy

作　　者：陈桑 耿丹明 吴琳琅 关朕 林玲 王鸿 Chen Sang;Geng Danming;Wu Linlang;Guan Zhen;Lin Ling;Wang Hong(Department of Ultrasound,the 900th Hospital of China Joint Logistic Support Force,Fuzhou 350025,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇〇医院超声诊断科,福州市350025

出　　处：《中国超声医学杂志》2023年第2期174-178,共5页Chinese Journal of Ultrasound in Medicine

基　　金：军民融合临床研究专项(No.2018J12)。

摘　　要：目的 探讨晚孕期胎儿房间隔膨胀瘤(FASA)致左右心比例不对称超声表现并评价其预后。方法 回顾性分析产前超声诊断中心检出晚孕期房间隔膨胀瘤(FASA)致左右心比例不对称的30例胎儿的产前超声心动图表现及随访结果。结果 30例胎儿产前超声表现:右心房横径/左心房横径(RAD/LAD)≥1.2胎儿30例,其中右心房横径/左心房横径≥1.5胎儿8例(26.7%);右心室横径/左心室横径(RVD/LVD)≥1.3胎儿21例(70%);肺动脉/主动脉(PA/AO)≥1.3胎儿20例(66.7%);足月胎儿主动脉峡部(AOI)≤3 mm,疑诊为主动脉缩窄(CoA)8例(26.7%)。膨胀瘤膨出深径/左心房横径(FOFD/LAD)与RVD/LVD、PA/AO呈正相关关系(P<0.001),FOFD/LAD与AOI呈负相关关系(P<0.005)。30例胎儿出生后随访心脏结构未见明显异常。结论 晚孕期FASA的膨出深径在左心房内比例越大,左右心比例不对称的程度越显著,主动脉及峡部越细。晚孕期FASA致胎儿容量性左心小、左右心比例不对称的特征性产前超声表现与胎儿CoA相似,但其预后良好。产前超声心动图能够对FASA进行全面、准确的评估,同时对胎儿围产期的监测和临床处理有重要指导意义。Objective To explore the ultrasonographic features and the prognostic significance of fetal atrial septal aneurysmin(FASA) complicated with ventricular size disproportion in the third trimester pregnancy. Methods We retrospective reviewed the ultrasonographic features and the follow-up data of 30 women with FASA who underwent fetal echocardiography in the Prenatal Ultrasound Diagnosis Center of our hospital in the third trimester pregnancy. Results The findings of 30 cases were as follows: There were 30 cases with a RAD/LAD ratio ≥1.2,of which 8 had a RAD/LAD ratio ≥1.5. 21 cases had a RVD/LVD ratio ≥1.3, while 20 cases had a PA/AO ratio ≥1.3. There were 8 cases with aortic isthmus internal diameter ≤3 mm in full-term who were suspected of aortic coarctation. There was a significant positivelinear correlation between RVD/LVD and PA/AO(P<0.001).The redundancy of FOF was negatively correlated with AOI(P<0.005). After birth, 30 fetuses were followed up with no obvious abnormalities in cardiac structure. Conclusions The larger the proportion of FOFD in the left atrium, the more significant degree of ventricular disproportion and the smaller the aortic isthmus diameter in the third trimester pregnancy. Prenatal echocardiographic features of fetal atrial septal aneurysm with small left heart and ventricular size disproportion may mimic the aortic coarctation, but the prognosis in fetuses with FASA is generally good. Prenatal echocardiography can comprehensively and accurately evaluate FASA, which is extremely vital for perinatal monitoring and clinical decision.

关 键 词：房间隔膨胀瘤 左右心比例不对称 晚孕期 产前超声 

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]