不同类型左头臂静脉异常胎儿超声心动图特征及临床意义  

Fetal Echocardiographic Features and Clinical Significance of Different Types Left Brachiocephalic Vein Abnormalities

作　　者：傅天恩 王泽城 廖瑞碧 吕国荣[2] 李丽雅[2] FU Tianen;WANG Zecheng;LIAO Ruibi;LV Guorong;LI Liya(Department of Ultrasound,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;不详)

机构地区：[1]泉州市儿童医院超声科,福建泉州362000 [2]福建医科大学附属第二医院超声科,福建泉州362000 [3]安溪县妇幼保健院超声科,福建泉州362400

出　　处：《中国医学影像学杂志》2023年第8期854-857,863,共5页Chinese Journal of Medical Imaging

基　　金：泉州医高专母婴健康服务应用技术协同创新中心。

摘　　要：目的 探讨正常胎儿左头臂静脉(LBCV)前后径与孕龄的关系,分析不同类型LBCV异常胎儿的超声心动图特征,并评估其临床意义。资料与方法 回顾性分析2015年1月—2020年1月来自泉州市儿童医院、福建医科大学附属第二医院、安溪县妇幼保健院共30例LBCV异常胎儿的超声心动图特征,并于三血管气管断面偏头侧的胸腺断面连续测量714例孕龄20~38周正常胎儿LBCV的前后径,分析孕龄与LBCV前后径的关系。结果 随着孕龄增加,LBCV前后径明显增加(r=60.084,P<0.001),其回归方程为Y=2.01+0.19×孕龄(F=0.914,P<0.001)。30例LBCV异常胎儿中,LBCV走行异常24例(主动脉弓下走行22例、食管后迷走1例、胸腺内走行1例),LBCV缺如4例,LBCV扩张2例;合并主动脉弓及其分支异常13例、圆锥动脉干畸形4例、室间隔缺损1例、心上型肺静脉异位引流1例、Galen静脉瘤1例。结论 产前超声心动图可用于评估胎儿LBCV,LBCV异常胎儿通常合并心脏畸形,评估胎儿LBCV有助于筛查胎儿先天性心脏病。Purpose To investigate the relationship between the anterior and posterior diameter of the left brachiocephalic vein(LBCV)and gestational age in normal fetuses,and to evaluate the characteristics of fetal echocardiography with different types of LBCV abnormalities and its clinical significance.Materials and Methods The echocardiographic characteristics of 30 cases of fetal LBCV abnormalities were retrospectively summarized in Quanzhou Children’s Hospital,the Second Affiliated Hospital of Fujian Medical University and Anxi County Maternal and Child Health Hospital from January 2015 to January 2020.The anteroposterior diameter of 714 normal fetal LBCV in 20-38 weeks were continuously measured on the thymus section on the cephalic side of the three-vessel trachea,and the relationship between the gestational age and the anteroposterior diameter of LBCV was analyzed.Results With the increase of gestational age,the anteroposterior diameter of LBCV increased significantly(r=60.084,P<0.001),and the regression equation was Y=2.01+0.19×gestational age(F=0.914,P<0.001).Among the 30 fetuses,there were 24 cases with abnormal LBCV walking,including 22 cases with under the aortic arch,1 case with posterior esophageal vagus,and 1 case with intrathymus.There were 4 cases without LBCV and 2 LBCV cases with dilation.There were 13 cases with fetal aortic arch and its abnormal branches,4 cases with conotruncal defects,1 case with ventricular septal defect,1 case with supracardiac anomalous pulmonary venous connection,and 1 case with vein of Galen malformation.Conclusion Prenatal echocardiography may be used to assess fetal left brachiocephalic trunk veins.LBCV abnormalities maybe often associated with fetal heart malformations.Evaluation of fetal LBCV may be helpful for screening fetal congenital heart disease.

关 键 词：左头臂静脉 先天性心脏病 超声心动图 胎儿 

分 类 号：R541.1[医药卫生—心血管疾病] R714.53[医药卫生—内科学] R445.1[医药卫生—临床医学]