胎儿心肌致密化不全的超声心动图诊断  

Echocardiographic Diagnosis of Fetal Myocardial Non-Compaction

作　　者：武莉娜 朱兆领[1] 孙园园 魏常华[1] 谢苗苗 王睿丽[1,2,3] WU Lina;ZHU Zhaoling;SUN Yuanyuan;WEI Changhua;XIE Miaomiao;WANG Ruili(Department of Ultrasound,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Ultrasound,Zhengzhou University People's Hospital,Zhengzhou 450003,China;Department of Ultrasound,Henan University People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院超声科,河南郑州450003 [2]郑州大学人民医院超声科,河南郑州450003 [3]河南大学人民医院超声科,河南郑州450003

出　　处：《中国医学影像学杂志》2024年第10期1042-1045,共4页Chinese Journal of Medical Imaging

摘　　要：目的探索胎儿心肌致密化不全的超声特征及早期诊断线索。资料与方法回顾性分析2015年1月—2023年2月河南省人民医院行胎儿超声心动图检查且经病理或产后检查证实为心肌致密化不全4例胎儿的临床与超声心动图资料。结果4例胎儿中累及左心室2例,病变呈孤立性,产后超声心动图证实为心尖部心肌致密化不全;累及双心室2例,均引产后经病理证实。4例胎儿受累心肌产前超声表现:(1)呈双层结构:外层为致密化心肌,表现为薄而致密的均匀低回声;内层为疏松、增厚的非致密化心肌,回声增强;(2)彩色多普勒血流成像见非致密化心肌内可见筛网状血流与心室相通。部分病例伴有心脏增大、心律失常等表现。结论产前超声心动图可诊断胎儿心肌致密化不全,且其超声表现具有一定特征。心肌局部增厚、回声增强;心脏增大;心律失常等可能作为识别胎儿心肌致密化不全的重要线索。Purpose To explore the ultrasound features and early diagnostic clues of fetal myocardial non-compaction.Materials and Methods The clinical data and echocardiographic data of four fetuses who underwent fetal echocardiography in Henan Provincial People's Hospital from January 2015 to February 2023 and were confirmed to have myocardial non-compaction by pathological finding or postnatal examination were collected,and analyzed.Results A total of four fetuses diagnosed as myocardial non-compaction by prenatal ultrasound:two involved the left ventricle with isolated lesions,and apical myocardial non-compaction was confirmed by postnatal echocardiography;two involved the biventricles,and both of which were pathologically confirmed after induction of labor.The prenatal ultrasound of fetal myocardial involvement in four cases showed that:(1)the affected myocardium showed a bilayer structure:the outer layer was compacted myocardium,which showed thin and compacted homogeneous hypoechoic;the inner layer was loose and thickened non-compacted myocardium with enhanced echogenicity;(2)color Doppler flow imaging:the non-compacted myocardium showed sieve mesh blood flow with ventricular communication.Some cases were associated with cardiac enlargement and arrhythmia.Conclusion Prenatal echocardiography can diagnose fetal myocardial non-compaction with a characteristicechographic presentation.Localized myocardial thickening and echogenicenhancement,cardiac enlargement and arrhythmia may be important clues to identify fetal myocardial non-compaction.

关 键 词：胎儿疾病 心肌致密化不全 超声检查 产前 

分 类 号：R714.55[医药卫生—妇产科学] R542.2[医药卫生—临床医学] R445.1