| 罗长锐,谷孝艳,王斯宇,何怡华.胎儿主肺动脉窗产前超声心动图特征[J].中国医学影像技术,2018,34(12):1848~1851 |
| 胎儿主肺动脉窗产前超声心动图特征 |
| Prenatal echocardiographic characteristics of fetal aortopulmonary window |
| 投稿时间：2018-04-09 修订日期：2018-09-07 |
| DOI：10.13929/j.1003-3289.201804046 |
| 中文关键词: 胎儿 主肺动脉窗 超声检查,产前 |
| 英文关键词:Fetus Aortopulmonary window Ultrasonography, prenatal |
| 基金项目:深圳市三名工程资助（SZSM201612027）、北京市卫生系统高层次卫生技术人才培养计划（2015-3-049）、扬帆计划临床技术创新项目（XMLX201604）、首都卫生发展科研专项重点攻关项目（2016-1-2061）。 |
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| 中文摘要: |
| 目的 探讨胎儿主肺动脉窗（APW）的产前超声心动图特点。方法 回顾性分析经产前超声诊断的16胎APW胎儿的超声心动图特点，包括APW缺损部位、大小、分型、分流情况及合并其他心内、心外畸形情况。结果 胎儿超声心动图诊断的16胎APW胎儿中，引产10胎，出生2胎，失访4胎。4胎接受尸体解剖的胎儿引产标本中，3胎超声心动图结果与病理结果一致，1胎病理证实为共同动脉干。2例出生后接受手术治疗，其超声心动图结果均与手术结果一致。15胎APW中，Richardson Ⅰ型2胎（2/15，13.33%），Ⅱ型9胎（9/15，60.00%），Ⅲ型4胎（4/15，26.67%）。APW超声心动图特点为三血管切面或左心室流出道、右心室流出道切面可见主动脉与肺动脉之间的间隔回声失落，CDFI示大动脉水平可见双向分流信号。15胎均合并其他心内、心外畸形，包括主动脉弓异常6胎（6/15，40.00%）、室间隔缺损6胎（6/15，40.00%）、肺动脉异常6胎（6/15，40.00%）、动脉导管异常5胎（5/15，33.33%）、静脉异常4胎（4/15，26.67%）、圆锥动脉干畸形3胎（3/15，20.00%）、Berry综合征3胎（3/15，20%）、法洛四联症1胎（1/15，6.67%）、单脐动脉1胎（1/15，6.67%）。结论 产前超声心动图对APW具有诊断价值，能准确评估APW缺损部位、大小、分型及血流情况，可作为首选检查方法。 |
| 英文摘要: |
| Objective To explore prenatal echocardiographic characteristics of fetal aortopulmonary window (APW). Methods Prenatal echocardiographic characteristics of 16 fetuses with APW were retrospectively analyzed, focused on the location, size, type, split of the defects of APW and other combined intracardial and extracardial malformations. Results Among 16 fetuses with ultrasonic diagnosed APW, 10 underwent induced labor, 2 were born and 4 were lost to follow-up. Postmortem examination was performed in 4 fetuses, 3 were found consistent with the pathological results, and 1 was confirmed as truncus arteriosus and misdiagnosed as APW. Two cases received surgical treatment after birth, and the echocardiographic findings of APW were proved during operation. Among 15 fetuses with true APW, 2 (2/15, 13.33%) were Richardson type Ⅰ, 9 (9/15, 60.00%) were type Ⅱ and 4 (4/15, 26.67%) were type Ⅲ. The echocardiographic characteristics of APW were echo loss at the interval between aorta and pulmonary artery on three vascular section or left and right ventricular outflow tract aspects, while CDFI showed bidirectional shunting signal on the artery levels. All 15 APW fetuses were combined with other intracardial or extracardial malformations, such as aortic arch anomalies (6/15, 40.00%), ventricular septal defect (6/15, 40.00%), pulmonary artery anomaly (6/15, 40.00%), arterial duct anomaly (5/15, 33.33%), venous anomaly (4/15, 26.67%), conotruncal anomaly (3/15, 20.00%), Berry syndrome (3/15, 20.00%), tetralogy of Fallot (1/15, 6.67%) and single umbilical artery (1/15, 6.67%). Conclusion Echocardiography has good diagnostic value for fetal APW, which can accurately assess the location, size, classification and blood flow of aortopulmonary septal defect, and may be regarded as the preferred method for prenatal diagnosis of APW. |
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