不同初始切面胎儿心脏三维容积包成像在胎儿心脏超声检查中的价值

目的 研究不同初始切面胎儿心脏三维容积包图像质量,探讨三维成像技术联合断层超声显像技术在正常胎儿心脏超声检查中的价值.方法 应用胎儿三维成像技术对158例胎儿(孕16~40周)心脏以心尖四腔心切面和胸骨旁四腔心切面作初始切面采集三维容积数据.应用软件进行离机分析,用断层超声显像模式对胎儿四腔心、五腔心、三血管气管、左心室流出道、右心室流出道、大动脉短轴、主动脉弓、动脉导管弓、上下腔静脉长轴9个标准切面进行显示.按不同孕龄将158例胎儿分为3组,A组(16~24周)、B组(25~32周)和C组(33~40周),对3组胎儿9个标准切面显示情况进行组间对比分析.结果 应用心脏三维容积技术在158例胎儿中采集到满意的心脏容积数据包图像149个,其中心尖四腔心切面容积包72个,胸骨旁四腔心切面容积包77个.(1)上下腔静脉切面、大动脉短轴切面图像清晰显示率(2分切面率),心尖四腔心切面容积包图像及胸骨旁四腔心切面容积包图像的A组与B组间对比,差异均有统计学意义(心尖四腔心切面容积包χ2=4.927、22.938,胸骨旁四腔心切面容积包χ2=6.312、21.761,P均<0.05).(2)主动脉弓切面、动脉导管弓切面图像清晰显示率(2分切面率),仅在心尖四腔心切面容积包图像的A组与B组间对比差异有统计学意义(χ2=8.053、4.967,P均<0.05).(3)心尖四腔心切面容积包和胸骨旁四腔心切面容积包B组图像清晰显示率最高,C组其次,A组最低.结论 心尖四腔心切面和胸骨旁四腔心切面均可作为胎儿心脏三维容积成像采集初始切面,三维容积成像中重建切面受外部条件影响明显.胎儿心脏三维超声检查最佳孕龄范围为25~32孕周,孕龄大小对以心尖四腔心作初始切面的心脏三维图像质量影响较大.这两个初始切面可为胎儿心脏三维容积图像规范化采集和远程会诊图像规范化采集提供参考.     

初始切面对胎儿心脏时-空相关成像技术应用的影响研究

目的 比较不同初始切面采集的容积数据对胎儿心脏各标准切面的显示率,探讨三维超声扫查中不同初始切面对心脏容积数据质量的影响.方法 在本院产检的18～28孕周的孕妇60例,胎儿系统超声检查及出生后随访无异常.分别以胎儿胸骨旁四腔心切面(A组)、心尖四腔心切面(B组)及主动脉弓长轴切面(C组)为初始切面,采用三维超声时-空相关成像技术(spatio-temporal image correlation,STIC)扫查并存储容积数据.应用软件分析容积数据,统计3组容积数据对胎儿心脏四腔心、五腔心、左心室流出道、右心室流出道、大动脉短轴、三血管气管、上下腔静脉纵切面、主动脉弓长轴及动脉导管长轴等9个标准切面的显示率,比较3组差异.结果 采集104个容积数据,A组49个,B组30个,C组25个.各组对胎儿心脏9个标准切面的总显示率分别为:A组97.7%,B组94.1%,C组91.6%(PA-B-C＜0.05),B组对心脏各长轴切面、C组则对心脏各短轴切面显示率较低.结论 胎儿心脏三维超声STIC扫查中,不同初始切面影响所采集的容积数据对心脏9个标准切面的显示,胸骨旁四腔心切面为最佳初始切面.     

断层超声显像技术联合时间空间相关成像技术和四腔心平面头侧偏斜法在胎儿心脏畸形筛查中的初步研究

目的探讨断层超声显像技术联合时间空间相关成像技术(TUI-STIC技术)和四腔心平面头侧偏斜法(FCPTC)在胎儿心脏畸形筛查中的应用价值。方法采用时间空间相关成像(STIC)技术在不同体位四腔心切面(心尖四腔心位、胸骨旁四腔心位和心底四腔心位)采集胎儿心脏容积图像,脱机应用断层超声显像(TUI)技术进行分析,显示四腔心、五腔心和三血管切面;同时采用FCPTC法显示四腔心、五腔心和三血管切面。结果心尖四腔心位、胸骨旁四腔心位时TUI-STIC技术和FCPTC法比较无统计学差异(P>0.05);心底四腔心位时TUI-STIC技术和FCPTC法两者比较有统计学差异(χ2=0.039,P<0.05)。结论 TUI-STIC技术和FCPTC法均可应用于胎儿心脏畸形筛查;中孕期心底四腔心位时应用TUI-STIC技术可降低胎儿心脏畸形筛查的难度。     

超声断层显像与常规二维超声进行胎儿心脏筛查的比较研究

目的 比较超声断层显像(TUI)技术与常规二维超声进行胎儿心脏筛查的图像显示合格率和图像质量,分析TUI进行胎儿心脏筛查的可行性.方法 110例中孕期正常胎儿,利用时空关联成像(STIC)技术,一次性扫描获得整个心脏的容积数据,然后脱机分析,采用TUI法,调整层距、中心层位置后,分别在灰阶模式下及彩色多普勒血流模式下,重现胎儿心脏筛查所需要的四腔心切面,左、右室流出道切面和三血管切面.按事先确定的评分标准,分别对TUI重现图像及常规二维超声所获得切面进行评分比较,并统计图像显示合格率.结果 纳入研究的110例正常胎儿心脏中,在胎位相同的条件下,TUI法重现的四腔心切面,左、右室流出道切面及三血管切面灰阶图的显示率分别为100%、88.9%、80.0%、84.4%,常规二维超声显示率分别为100%、86.2%、50.0%、100%.TUI法重现各切面(灰阶图和血流图)的显示率与常规二维超声各相应切面的显示率比较差异均无统计学意义(P＞0.05).图像质量评分显示,仅在灰阶图中四腔心切面筛查图像评分低于TUI法,常规二维超声中右室流出道切面评分高于TUI法(P＜0.05),其余各切面比较差异均无统计学意义(P＜0.05).结论 TUI法重现的各切面基本能够达到与直接获得的二维切面相同的合格率和图像质量,可以满足中孕期胎儿心脏筛查离线分析的需要.     

断层超声显像技术联合时间空间相关成像技术在胎儿心脏筛查中的初步应用

目的 探讨断层超声显像(TUI)技术和时间空间相关成像技术在胎儿心脏筛查中的应用价值.方法 采用时间空间相关成像技术采集60例孕龄19～34周正常胎儿心脏容积图像,再应用断层超声显像技术脱机进行分析,再现四腔心、左室流出道、右室流出道和三血管气管切面.结果 所有60例胎儿均获得了满意的TUI图像,其中51例可直接获得上述4个筛查切面,9例需沿Y轴稍微旋转图像.结论 断层超声显像和时间空间相关成像技术可应用于胎儿心脏筛查,可降低胎儿心脏筛查的难度.     

胎儿实时三维(四维)超声心动图的初步临床应用

目的 以胎儿四腔心容积为基础,通过后处理,与二维超声比较,探讨胎儿四维超声心动图在显示正常胎儿心脏和先天性心脏畸形胎儿中的临床应用。方法 对108例孕妇行胎儿心脏四维超声检查,其中84例心脏正常、24例先天心脏畸形。显示胎儿四腔心切面后启动四维容积扫查获得心脏灰阶容积和彩色多普勒血流容积,将图像储存后进行后处理。获取容积与后处理由同一医师完成。利用上述容积显示如下结构：四腔心（4C）、左心室流出道（LVOT）、右心室流出道（RVOT）、三血管气管（3VT）、二尖瓣（MV）、三尖瓣（TV）、主动脉（AO）、肺动脉（MPA）、主动脉弓（ARCH）、动脉导管（DA）。比较正常胎儿孕周≥28周和<28周胎儿在不同四腔心初始位置下对同一结构显示率的差异。所有四维超声心动图的诊断结果与二维超声比较,其中11例先天心脏畸形经产后解剖或生后超声心动图证实。结果 108例胎儿均获得心脏四维容积数据（100%）。每个对象扫查时间（7.53±2.37）min,5 s/容积。四腔心与房室瓣显示率100%。除主动脉弓外,心脏正常胎儿孕周≥28周对上述心脏结构的显示率高于＜28周胎儿（P＜0.05）;除三血管气管切面外,心脏初始位置为心尖四腔心时对上述切面的显示率高于横位四腔心和心底四腔心（P＜0.05）。孕周与胎心初始位置对显示率有显著影响,孕周大、初始位置为心尖四腔心切面获取成功率较高。先天性心脏畸形胎儿24例,四维超声心动图在显示瓣膜、瓣环及心脏间隔上显示出优势。结论 以四腔心为基础切面能够快速获取胎儿心脏容积,并能较为完整地评价胎儿心脏结构。胎儿四维超声心动图在显示复杂胎儿心脏异常中起到一定的作用。     

初学者应用超声断层成像技术显示胎儿心脏结构的探索

目的探索超声断层成像（TUI）技术能否提高初学产科超声操作医师对胎儿心脏结构的显示率,了解该技术在胎儿心脏检查中的临床应用价值。方法先由一名熟练的产科超声医师（a）应用二维超声对200例正常中孕期胎儿的心脏进行检查并存储图像;再由一名初学产科超声的医师（b）应用时空关联成像（STIC）技术获取胎儿心脏的容积数据,然后应用TUI程序获得心脏检查各切面并保存;最后由一名超声医师（c）将同一胎儿心脏的二维图像与TUI重现的心脏各切面进行对比并根据切面图像的质量及诊断价值进行评分。结果200例正常胎儿心脏超声检查中,185例获得满意的容积数据。应用TUI技术能够获得胎儿心脏检查所需的切面,获取四腔心、左心室流出道、右心室流出道、三血管及胃泡切面的显示率分别为100．O％、92．2％、87．8％、98．9％及100．0％。TUI法获取各切面与常规二维切面的显示率比较,差异无统计学意义（P〉0．05）,符合产前超声检查的质量要求。结论TUI技术是一种简单易学的胎儿心脏结构超声显示方法,初学者应用该技术能够显示胎儿心脏超声检查的常用切面,该技术降低了培训超声医师检查胎儿心脏的难度,有利于超声检查胎儿心脏的推广应用。     

自动四维彩色容积超声在胎儿心脏检查中的应用

目的 探讨自动四维彩色容积超声在正常胎儿心脏检查中的应用价值.方法 对120例孕中期(18～23孕周)胎儿心脏进行四维容积扫查,在显示四腔心切面、启动彩色多普勒后采集胎儿胸部容积数据,利用超声自动多平面成像法自动获取3个诊断切面,分别为切面1(左心室流出道切面)、切面2(右心室流出道切面)及切面3(动脉导管弓切面),并采用超声断层显像法(TUI)显示所有切面的彩色血流图.对所有的容积数据进行分析并确定在每个容积数据中切面1～3是否正确显示.结果 通过自动四维彩色容积超声扫描,切面1～3的显示率分别为100%、96.67%、91.67%.切面1至少可在连续3个TUI图像上可靠显示,切面2和切面3均至少可在连续2个TUI图像上可靠显示.结论 自动四维彩色容积超声可自动获取胎儿心脏检查中所需的重要切面,显示率较高,并可观察相应切面的血流情况,显示效果良好.     

三维和二维超声对先天性心脏病儿童心脏标准切面的显示效果比较研究

目的探讨三维和二维超声对先天性心脏病儿童心脏标准切面的显示效果,为先天性心脏病儿童临床诊断提供参考。方法以我院109例先天性心脏病儿童,分为三维超声组(66例)和二维超声组(43例),比较两组儿童四腔心切面、上下腔静脉长轴切面、三血管及气管切面、左心室流出道切面、右心室流出道切面、主动脉弓长轴切面、动脉导管弓长轴切面的显示率差异,并比较四腔心切面和主动脉弓长轴切面容积数据扫描时,三维和二维超声对儿童其他心脏标准切面显示率差异。结果三维超声组对先天性心脏病儿童四腔心切面、上下腔静脉长轴切面、三血管及气管切面、左心室流出道切面、右心室流出道切面、主动脉弓长轴切面、动脉导管弓长轴切面的显示率均显著高于二维超声组(P均0.05);四腔心切面容积数据扫描时,三维超声组的上下腔静脉长轴切面、左心室流出道切面、右心室流出道切面的显示率与本身切面的显示率比较无差异(P均0.05),且高于二维超声组的显示率(P均0.05);主动脉弓长轴切面容积数据扫描时,三维超声组的动脉导管弓长轴切面、三血管及气管切面的显示率与本身切面的显示率比较无差异(P均0.05),且高于二维超声组的显示率(P均0.05)。结论三维超声对先天性心脏病儿童心脏标准切面的显示效果明显优于二维超声,同时联合四腔心切面和主动脉弓长轴切面容积数据进行心脏扫描,可有效显示先天性心脏病儿童心脏全部切面信息,因此可根据四腔心切面和主动脉弓长轴切面信息综合评价先天性心脏病儿童心脏功能。     

小儿冠状动脉超声显示的方法学研究

目的探讨正常小儿冠状动脉超声的操作技巧并观察冠状动脉的形态学改变,为早期诊断川崎病提供诊断依据.方法对160名正常儿童和40例川崎病患儿,根据冠状动脉的走行,结合心脏解剖断面,取左心室长轴、主动脉短轴、左心室短轴、心尖四腔心切面及非标准切面分段扫查.结果(1)正常左右冠状动脉主干长轴为2条平行直线,管壁纤细、回声均匀、腔内回声清晰;(2)胸骨左缘心底短轴、非标准左心室长轴、右心室流出道长轴、左心室二尖瓣水平短轴、心尖两腔心和五腔心切面分别可显示左冠状动脉主干、左前降支及左回旋支的长轴或短轴图像;(3)胸骨左缘心底短轴、非标准左心室长轴、右心室流入道(右心室两腔心)、心尖四腔心移行切面等可分别显示右冠状动脉主干及起始部、中段、远端(后降支).尤其是当冠状动脉有扩张时,冠状动脉各段都能很好显示.结论追踪冠状动脉走行,并结合心脏解剖断面,超声心动图对小儿冠状动脉能进行较完整的全程显示,从而可以准确判断冠状动脉是否有形态学改变.     

The 'spin' technique: a new method for examination of the fetal outflow tracts using three-dimensional ultrasound.

BACKGROUND AND OBJECTIVE: The prenatal detection of congenital heart defects remains one of the most difficult challenges for the sonologist/sonographer when performing the second- or third-trimester screening examination. The four-chamber view has been used for a number of years as the primary screening image for detection of heart defects, but the inclusion of the right and left outflow tracts increases the detection of cardiac malformations. One of the difficulties, however, is obtaining and interpreting two-dimensional images of the outflow tracts. This paper reviews a new technique using three-dimensional (3D) multiplanar imaging that allows the examiner to identify the outflow tracts within a few minutes of acquiring the 3D volume dataset by rotating the volume dataset around the x- and y-axes. METHODS: 3D multiplanar imaging of the fetal heart using static 3D or spatio-temporal image correlation (STIC) imaging allows the examiner to obtain a volume of data that can be manipulated along the x- and y-axes using reference points from the four-chamber view, five-chamber view, three-vessel view at the level of the bifurcation of the pulmonary arteries, and three-vessel view at the level of the transverse aortic arch and trachea. RESULTS: The full length of the main pulmonary artery, ductus arteriosus, aortic arch and superior vena cava could be identified easily in the normal fetus by rotating the volume dataset along the x- and y-axes. The vessels were identified using the four-chamber view, the five-chamber view, and the two three-vessel views. The technique was useful in identification of d-transposition of the great vessels and evaluation of the outflow tracts in hypoplastic left heart syndrome. CONCLUSION: 3D multiplanar evaluation of the fetal heart allows the examiner to identify the outflow tracts using a simple technique that requires only rotation around x- and y-axes from reference images obtained in a transverse sweep through the fetal chest.     

Incorporating the four-chamber view of the fetal heart into the second-trimester routine fetal examination.

The four-chamber view of the fetal heart is reported to he the most useful view for detecting congenital heart defects. In 7322 non-selected, consecutive pregnancies of women attending a second-trimester (18 weeks) routine ultrasound scanning program, we examined our ability to obtain a four-chamber view in the fetus within the 30 min generally allocated to do the scan and record data. Five trained nurse-midwives performed the examinations between June 1988 and September 1990. In the first part of the study, a four-chamber view could not be obtained in 7%, while in the second part, the failure rate was 4%, which showed a learning effect over time. The demonstration of a four-chamber view was significantly better with a 5 MHz than with a 3.5 MHz transducer. The ability to obtain the four-chamber view improved as the gestational age increased. The main reason for not being able to obtain the four-chamber view with the 3.5 MHz transducer was poor imaging; for the 5 MHz transducer, it was an unfavorable position of the fetus. Education and experience, as well as good equipment, are important factors in obtaining good results. The time spent learning to obtain a four-chamber view reliably was relatively long.     

Three-dimensional fetal echocardiography: gated versus nongated techniques.

The purpose of this study was to compare gated with nongated three-dimensional fetal echocardiography in terms of the ability to demonstrate fetal cardiac anatomy. We examined nine fetuses in utero using conventional two-dimensional sonographic imaging equipment, an electromagnetic position sensor, and a computer-graphics workstation. Free-hand sweeps were performed through the fetal heart and great vessels in either transverse or sagittal orientations with respect to the fetal heart. Seven transverse and five sagittal sweeps were selected for reconstruction and analysis. Cardiac gating was performed by using a temporal Fourier transform to determine the fundamental frequency of cardiac motion. Two-dimensional data from each sweep were reprojected to a series of volume data sets. Each series was then condensed to a single volume, so that each two-dimensional sweep could be compared with its respective gated and nongated volume data sets. The two-dimensional data were reviewed utilizing a display with forward and backward cineloop capability. The gated and nongated volume data sets were displayed interactively as a series of three orthogonal planes, with the ability of the observer to control the location of each image plane within the volume. The gated data were animated with variable display frame rates. Conventional two-dimensional imaging provided a fairly complete evaluation of the fetal heart when scanning included the four-chamber view with a sweep across the outflow tracts. Nongated three-dimensional fetal echocardiography allowed visualization of some structures and views not demonstrated with two-dimensional ultrasonography. Gated three-dimensional fetal echocardiography provided significantly better visualization and comprehension of cardiac anatomy than nongated three-dimensional fetal echocardiography. The superiority of gated over nongated three-dimensional fetal echocardiography appears to come from both improved image quality and the anatomic clues that derive from the ability to view cardiac motion.     

胎儿超声断层解剖模式图设计与应用:胎儿四腔心切面异常表现

目的研究胎儿四腔心切面异常的各种超声表现并绘制成各种模式图,提高产前超声医师对异常四腔心切面的识别能力。方法将我们9年多的胎儿心脏超声检出的、并经病理解剖或产后手术证实的各种心脏异常的典型病例,用模式图的形式绘制出它们在四腔心切面上的典型特征,直观地展现其诊断与鉴别诊断特征。模式图均以左位心的形式表现出来(不包括心脏位置异常)。结果共绘制出16组47种四腔心切面的异常表现模式图。结论四腔心切面异常模式图的绘制对提高对心脏畸形的认识有帮助,为诊断更为复杂的先天性心脏畸形打下坚实基础。     

Four-chamber view of the fetal heart: demonstration related to menstrual age.

The four-chamber view of the fetal heart is the most widely used screening examination for the detection of structural cardiac abnormalities during routine fetal ultrasonography. A prospective study of 520 consecutive routine fetal sonograms taken between 13 and 39 weeks of gestational age was performed to determine the frequency of obtaining a satisfactory four-chamber view, focusing on fetuses of less than 19 weeks' menstrual age. Menstrual age was a significant variable in procuring a satisfactory four-chamber view. Visualization of a normal four-chamber view on film progressively increased from five out of 15 (33%) at 14 weeks of menstrual age to 35 out of 38 (92%) at 19 weeks of menstrual age; real-time evaluation improved visualization to six out of 15 (40%) at 14 weeks of menstrual age and to 36 out of 38 (95%) at 19 weeks of menstrual age. Visualization in all fetuses scanned before 19 weeks' menstrual age improved from 62 (on film only) to 75% (real-time and film). Abnormalities on the four-chamber view were demonstrated before 19 weeks of menstrual age in four cases. Although not all serious cardiac defects can be detected, the four-chamber view remains a reliable screening examination of the fetal heart even early in gestation.     

Fetal echocardiographic evaluation of atrial morphology and the prediction of laterality in cases of heterotaxy syndromes.

OBJECTIVE: To evaluate whether abnormal atrial morphology, which is well recognized in autopsy series, is detectable by fetal echocardiographic examination of the four-chamber view, and can therefore be utilized to differentiate left from right isomerism in heterotaxy syndromes. METHODS: This study was a retrospective review of 30 cases with prenatally diagnosed heterotaxy syndromes. Ultrasound video recordings and still images were reviewed with respect to atrial morphology in the four-chamber view. In 25 cases the morphology of both atria was sufficiently well visualized on the recordings to be evaluated and only these were included in the study. RESULTS: Two types of atrial morphology were distinguished in our cohort: a sickle-shape with the tip pointing laterally and apically, and a blunt shape resembling the usual atrial appearance in the four-chamber view. Nineteen out of the 25 cases (76%) presented with isomerism of the atria in the four-chamber view. Thirteen had bilateral sickle-shaped atrial morphology, all associated with left isomerism. Six had bilateral blunt-shaped atrial morphology, all associated with right isomerism. The atria of the remaining six cases were not isomeric, the right atrium being sickle-shaped and the left blunt-shaped. Five of the latter cases were associated with left and one with right isomerism. CONCLUSIONS: The majority of prenatally diagnosed heterotaxy syndromes seem to present with isomeric atrial morphology in the four-chamber view. In these cases a differentiation between left and right isomerism can be based on the two distinct types of atrial morphology. This may further enhance the prenatal differentiation of these syndromes.     

六种超声方法估测左室射血分数的准确性比较

本文对５２例心脏病患者进行两维超声心动图检查，利用６种测左室射血分数（ＬＶＥＦ），并与平衡法核素心室造影获得的ＬＶＥＦ进行直线相关分析及配对ｔ检验。结果显示：６种超声方法获得的ＬＶＥＦ均与核素ＬＶＥＦ高度相关。其中尤以双平面Ｓｉｍｐｓｏｎ法获得的ＬＶＥＦ与核素ＬＶＥＦ相关最佳。但６种超声方法ＬＶＥＦ测值均低于核素ＬＶＥＦ，其中３种超声方法测得的ＬＶＥＦ与核素ＬＶＥＦ有显著性差异。     

产前超声诊断胎儿左心发育不良综合征

目的探讨胎儿左心发育不良综合征产前超声诊断方法 ,提高诊断准确性。方法常规产前超声检查方法 ,应用四腔心切面和三血管气管平面进行胎儿心脏畸形筛查。结果 2006年1月2008年12月发现4例左心发育不良综合征,3例并发心内畸形（2例右室双出口及1例室缺）,1例并发心外畸形（Dandy-Walker畸形及单脐动脉）。结论应用四腔心切面和三血管气管平面筛查心室发育不良简单易行,准确性高。     

时间-空间关联成像技术A平面平推＋旋转法快速筛查孕中期胎儿心脏结构

目的 评价时间-空间关联成像(STIC)技术A平面平推＋旋转法在快速筛查孕中期胎儿心脏结构中的应用.方法 将常规超声检查正常的胎儿400胎分为常规扫查组(200胎)和STIC组(200胎),根据胎儿心脏与探头的相对位置,将STIC组胎儿分为心尖四腔心、横位四腔心及心底四腔心3个亚组.对STIC组使用A平面平推法获得上腹部横切面、四腔心切面、左心室流出道、右心室流出道及三血管切面,并进行动态连续观察; 在三血管切面的基础上,使用A平面旋转法获得主动脉弓及动脉导管弓切面.计算两组胎儿心脏筛查所需时间,评价STIC各亚组所获得图像的质量.结果 应用STIC技术进行胎儿心脏筛查,用时较常规超声筛查明显缩短.心尖四腔心及横位四腔心亚组所获图像质量优于心底四腔心亚组 (P均<0.01).结论 与常规扫查方法相比,应用STIC技术A平面平推法＋旋转法可快速筛查孕中期胎儿心脏结构,具有重要临床应用价值.     

胎儿心脏后区域异常与胎儿畸形的关系研究

目的 研究四腔心观心脏后区域异常与胎儿畸形的关系,探讨胎儿常规超声检查中观察心脏后区域的临床价值。方法 行产前系统超声检查的7062例胎儿,超声检查心内和心外各脏器结构,四腔心切面观察心脏后区域。结果 产前超声共发现53例胎儿四腔心观心脏后区域异常,占0.8％ (53/7062)。37例经产后尸解证实,其中内脏异位综合征73.0％(27/37),完全性内脏反位8.1％(3/37),心脏畸形18.9％(7/37)。结论心脏后区域异常与胎儿畸形有密切的关系。四腔心观心脏后区域异常观察方法简单,可以作为产前筛查内脏转位和心血管畸形的有效超声标志。