多普勒超声评价胎儿房间隔瘤与房音隔缺损的相关性

目的 应用多普勒超声诊断胎儿房间隔瘤（ＡＳＡ）并评价与房间隔缺损（ＡＳＤ）的相关性。方法 对１０２０例胎儿进行多普勒超声心动图检测。结果 被检出的８例ＡＳＡ中３例合并中央型ＡＳＤ，其中２例伴严重的房性心律失常和三尖瓣反流；１例出生后复查示ＡＳＡ伴裂隙样小ＡＳＤ；２例出生后示卵圆孔（ＦＯ）未闭；２例瘤体缩小及１例消失。结论 ①胎儿ＡＳＡ的发生可能与妊娠早期ＦＯ处帘膜形成或继发隔的发育异常有关，因此与ＡＳＤ密切相关；②ＡＳＡ合并ＡＳＤ时更易诱发房性心律失常；③单纯的ＡＳＡ出生后常见ＦＯ未闭或小的房内分流而可能导致局部血栓物质的形成造成栓塞。

Assessment of the association of atrial septal aneurysm with atrial septal defect by Doppler echocardiography

Objective To diagnose fetal atrial septal aneurysm(ASA) and assess its association with atrial septal defect(ASD) by Doppler echocardiography.Methods One thousand and twenty fetuses were examined by Doppler ultrasonography. Results Eight fetuses were diagnosed ASA, three of which also had ASD. Two fetuses with ASD showed serous atrial arrhythmia and tricuspid regurgitation. One was born with small ASD and two with unclosed foramen oval (FO). The aneurysm shrank in two patients and disappeared in one within the neonatal period.Conclusions Fetal ASA may be associated with the formation of foramen oval's membrane in early pregnancy or secondary growth abnormality of heart septum. ASA tends to cause atrial arrhythmia more easily when accompanied by ASD. Unclosed FO or small shunting, which may cause embolism, is frequently detected in neonates with a history of uncomplicated fetal ASA.