胎儿静脉导管异位引流至冠状静脉窦产前超声表现:3例报告及文献复习

目的 结合文献及3例临床所见，观察胎儿静脉导管（DV）异位引流至冠状静脉窦（CS）产前超声表现。方法 回顾性分析3胎DV异位引流至CS胎儿，结合文献复习观察其产前超声特征。结果 产前超声于3胎四腔心后切面均见CS扩张，内径分别为3.6、8.2及4.8 mm；DV异位引流至扩张的CS。于1胎（序号1）见4支肺静脉汇入左心房（LA），DV经房间隔后方于左心房顶绕行至扩张的CS；1胎（序号2）三血管气管切面肺动脉主干左侧见永存左上腔静脉（PLSVC），旋转探头追踪观察发现DV与CS相连；1胎（序号3）4支肺静脉均回流入LA，三血管气管切面见主动脉弓位于气管右侧、左锁骨下动脉起自降主动脉起始部。结论 产前超声观察胎儿DV异位引流至CS四腔心后切面可见CS扩张，并可合并其他血管畸形。

Prenatal ultrasonic manifestations of fetal ductus venosus ectopic drainage into coronary sinus: Report of 3 cases and literature review

Objective To observe the prenatal ultrasonic manifestations of fetal ductus venosus (DV) ectopically drainage into coronary sinus (CS) combining findings of 3 cases and literature review. Methods Data of 3 fetuses with DV ectopic drainage into CS were retrospectively analyzed, and the prenatal ultrasonic characteristics were observed combining with literature review. Results Prenatal ultrasound showed CS dilation on four chamber posterior view in all 3 fetuses, and the dilated inner diameters of CS was 3.6, 8.2 and 4.8 mm, respectively. DV ectopically drained to the expanded CS. Besides, ultrasound showed 4 pulmonary veins flowed into the left atrium (LA), while DV bypassed the left atrium roof behind the atrial septum to the expanded CS in No.1 fetus. Perpetuate left superior vena cava (PLSVC) was found on the left side of pulmonary artery trunk on three vessel trachea view in No.2 fetus, and then tracking observation showed DV connected with CS. Four pulmonary veins were found flowed back to LA in No.3 fetus, and three vessel trachea view showed that the aortic arch located on the right side of trachea, and the left subclavian artery started from the beginning of descending aorta. Conclusion Prenatal ultrasonic findings of fetal DV ectopic drainage into CS included CS dilation on four chamber posterior view, and sometimes complicated with other vascular malformations.