应用胎儿超声心动图技术早期诊断动脉导管依赖型先天性心脏病

目的：探讨胎儿超声心动图对动脉导管依赖型先天性心脏病的临床诊断价值。方法：回顾分析16例经证实的动脉导管依赖型先心病的胎儿超声心动图资料，观察四腔心切面、三血管切面、左室流出道、右室流出道切面、主动脉弓和动脉导管弓长轴切面以及上下腔静脉汇入右房切面，总结其异常声像图特点，探索应用胎儿超声心动图技术诊断该类疾病的规律和方法。结果：根据生命依赖导管的作用及胎儿超声心动图改变，笔者将其分为三种类别，分别为以右心发育不良为代表的右心梗阻型、以左心发育不良为代表的左心梗阻型、室间隔完整的大动脉转位。结论：胎儿超声心动图可以早期发现和诊断动脉导管依赖型先心病，为进一步的治疗创造机会。左、右心相同节段对比显示法及彩色多普勒三血管切面血流显像具有重要价值。

Prenatal diagnosis of ductal-dependent congenital heart disease by fetal echocardlograpny

Objective To explore the clinical value of fetal echocardiography in the detection of ductal-dependent congenital heart disease.Method The prenatal ultrasonographic characteristics,postnatal corpse anatomy,their complicating anomalis and results were analyzed retrospectively in 16 cases with ductus-dependent congenital heart disease.All patients were referred for fetal echocardiography including four-chamber and three vessels,outflow tracts,short-axis views,then the aortic arch and ductal arch long-axis view.We reviewed the fetal sonograms and medical records of 16 fetuses with prenatal diagnosis of ductus-dependent congenital heart disease.Results We examined 16 cases with fetal ductus-dependent congenital heart disease,and divided 16 cases into 3 types by ductal dependence hemodynamic change:Right ventricular hypoplasia type;left ventricular hypoplasia type and complete ventricular septal transposition of great arteries type.Conclusion Current advances in fetal echocardiography have given us the ability to detect and classify ductal-dependent congenital heart disease in fetuses very early in gestation,it is possible to take measure to save these fetuses by fetal cardiac intervention.The contrast examination of the same level segment for left and right heart and examination 3VV plane by CDFI provides essential information for detection and diagnosis of fetal ductus-dependent congenital heart disease.