胎儿法洛四联症的产前超声筛查及诊断

目的探讨彩色多普勒超声检查在产前诊断胎儿法洛四联症的价值和技巧。方法2010—2012年,在我院就诊待产,经产后证实为法洛四联症患儿8例,其中4例胎儿经尸解证实,4例产后超声心动图证实(2例已行手术治疗,2例随访中);采用四腔心+左、右流出道+三血管切面筛查心脏大血管,分析总结胎儿法洛四联症声图像特点。结果除1例漏诊外,其余7例产前超声筛查均作出正确诊断;法洛四联症胎儿期声图像特征主要表现为室间隔缺损、主动脉骑跨、肺动脉狭窄,右室壁增厚不明显,轻型法洛四联症容易漏诊。结论采用四腔心+左、右流出道+三血管切面筛查能减少胎儿法洛四联症漏诊,提高产前诊断率。

The prenatal ultrasound screening and diagnostic of tetralogy of Fallot in fetal

Objective To explore the values and skills of color Doppler uhrasonography in the prenatal diagnosis of fetal tetralogy of Fallot. Methods During 2010 to 2012, a total of 8 cases with tetralogy of Fallot were confirmed, of all 4 cases were confirmed by autopsy, four cases were diagnosed with postpartum echocardiography （two cases underwent surgery treatment, two cases followed-up）; the method of four-chamber, ventricular outflow tracts and three-vessel view was used to examine heart; the sonogram features of tetralogy of Fallot were analyzed. Results One case of tetralogy of Fallot was misdiagnosed, seven cases were accurately diagnosed with our method, the ultrasonic diagnostic accuracy was 87.5%（7/8）; the sonogram features of tetralogy of Fallot were ventricular septal defect, overriding aorta, pulmonary stenosis and non-significant hypertrophy of the right ventricular; the mild tetralogy of Fallot was easily misdiagnosed. Conclusions The skills of the prenatal diagnosis of tetralogy of Fallot including four-chamber, ventricular outflow tracts and three-vessel view can reduce misdiagnosis, and improve the accuracy rate of diagnosis of tetralogy of Fallot.