姜立新,沈国芳,应涛,胡兵.产前超声心动图诊断胎儿左心室发育不良综合征[J].中国医学影像技术,2010,26(12):2346~2349
产前超声心动图诊断胎儿左心室发育不良综合征
Prenatal echocardiography in diagnosis of fetal hypoplastic left heart syndrome
投稿时间:2010-08-16  修订日期:2010-09-04
DOI:
中文关键词:  左心室发育不良综合征  胎儿  超声心动描记术
英文关键词:Hypoplastic left heart syndrome  Fetus  Echocardiography
基金项目:
作者单位E-mail
姜立新 上海交通大学附属第六人民医院超声医学科, 上海 200233  
沈国芳 上海交通大学附属第六人民医院超声医学科, 上海 200233  
应涛 上海交通大学附属第六人民医院超声医学科, 上海 200233  
胡兵 上海交通大学附属第六人民医院超声医学科, 上海 200233 hubinghifu@163.com 
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中文摘要:
      目的 探讨胎儿超声心动图诊断左心室发育不良综合征(HLHS)的临床价值。方法 对18胎HLHS胎儿的临床资料进行回顾性研究,分析其超声心动图特征。结果 18胎HLHS胎儿的超声心动图结果:①心尖四腔心切面:左心室小、心室发育不良。8胎二尖瓣及主动脉瓣闭锁,且左心室重度发育不良;5胎二尖瓣闭锁合并主动脉瓣狭窄及主动脉缩窄;3胎二尖瓣狭窄伴主动脉瓣狭窄及主动脉弓缩窄;2胎二尖瓣狭窄伴主动脉瓣闭锁及主动脉弓缩窄。②三血管切面:主动脉内径明显小于肺动脉,主动脉与肺动脉内径比值为0.25~0.40,平均0.38±0.18,主动脉横弓与动脉导管、肺动脉血流方向相反。③胸骨旁四腔心切面:6胎房间隔增厚,未显示房间隔穿隔血流。12胎胎儿卵圆孔径偏小、显示房间隔左向右分流。结论 胎儿超声心动图可早期诊断胎儿HLHS,结合染色体检查对围生期的监测和临床处理有重要意义。
英文摘要:
      Objective To observe the clinical value of fetal echocardiography in the diagnosis of fetal hypoplastic left heart syndrome (HLHS). Methods Echocardiographic features and clinical data of 18 fetuses prenatally diagnosed with HLHS were analyzed retrospectively. Results The findings of 18 fetal echocardiogram were as followed: ①Eight fetuses were found with aortic and mitral valve atresia and severe left ventricular dysplasia, 5 with mitral valve atresia and various degrees of aortic stenosis as well as aortic arch coarctation, 3 with thickened mitral valve, aortic stenosis and aortic arch coarctation, while 2 with thickened mitral valve, aortic atresia atreasia and aortic arch coarctation. ②The diameter of aorta was smaller than that of pulmonary artery. The ratio of AO/PA was 0.25—0.40 (0.38±0.18). There was reverse flow from ductus artery to the aortic arch and ascend aortic. ③Intact atrial septum and thickeness appeared in 6 fetuses. No blood shunt was detected in intact atrial septum. Other 12 fetuses presented few left to right shunts. Conclusion Fetal echocardiography may serve as a reliable methods for early diagnosis of fetal HLHS. It is important for the detection during the parental period and the guidance of the clinical treatment.
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