胎儿心脏超声检查常见误诊与漏诊分析

目的 分析胎儿心脏超声检查中几种较常见易误诊、漏诊疾病的超声特点。方法 回顾性分析接受胎儿心脏超声检查6745名孕妇共6848胎和出生后接受随访的332例新生儿和婴幼儿资料,分析常见易误诊、漏诊疾病的超声特点。结果 心脏畸形胎儿969胎,其中2胎完全型大动脉转位为首诊漏诊,5胎卵圆孔受限误诊为左心室发育不良。出生后于我院随访的新生儿及婴幼儿332例,与出生前检查结果不一致者9例,包括产前可疑轻度主动脉缩窄而出生后正常5例、产前诊断肺动脉瓣狭窄但出生后未见异常1例、漏诊威廉综合征2例、漏诊心内型肺静脉异位引流1例。结论 胎儿心脏超声检查中一些心脏畸形极易漏诊和误诊,对这些疾病的诊断困境和难点进行关注和探讨,有助于提高产前诊断质量。

Cause analysis of misdiagnosis and missed diagnosis diseases in fetal echocardiography

Objective To analyze the fetal echocardiographic characteristics of some prone to be misdiagnosed and missed diagnosed diseases. Methods The data of 6745 pregnant women including 6848 fetuses underwent echocardiography, and 332 postnatal cases followed up was retrospectively analyzed, and the echocardiographic characteristics of prone to be misdiagnosed and missed diagnosed diseases were analyzed. Results Totally 969 fetuses with cardiac malformations were diagnosed by prenatal ultrasound, in which 2 fetuses with transposition of great arteries were miss diagnosed, 5 cases with restrictive foramen ovale were misdiagnosed as left heart hypoplasia. In 332 postnatal cases followed up, 9 cases had the inconsistent results with prenatal diagnosis:5 cases prenatal diagnosed as suspected mild coarctation of aorta, and 1 case prenatal diagnosised as pulmonary stenosis were all normal; 2 cases with Williams syndrome and 1 case with anomalous pulmonary venous drainage were all miss diagnosed. Conclusion There are a few of diseases which are common in misdiagnosing and missed diagnosing, more concern should be focused on the diagnostic dilemma and difficulties of these diseases, which will improve the quality of prenatal diagnosis.