胎儿部分型及过渡型房室间隔缺损的产前超声诊断特点

目的 探讨产前超声诊断胎儿部分型及过渡型房室间隔缺损的价值。方法 回顾性分析11例经尸体解剖和产后超声心动图证实的部分型及过渡型房室间隔缺损胎儿的产前超声表现，总结其声像图特征。 结果胎儿超声心动图显示，7例部分型和4例过渡型房室间隔缺损在四腔心切面均显示原发孔型房间隔缺损，二尖瓣和三尖瓣在室间隔的附着点位于同一水平，关闭时与室间隔构成“T”字形图像。7例部分型房室间隔缺损中1例伴有左室-右房通道；4例过渡型房室间隔缺损均伴有室间隔上部缺损。11例胎儿中伴有二尖瓣反流4例，二、三尖瓣反流1例，双侧桡骨缺如1例。 结论产前超声观测心脏“T”字形声像图特征对诊断胎儿部分型和过渡型房室间隔缺损具有重要临床价值，但应注意与冠状静脉窦形成的假象鉴别。

Ultrasound diagnosis of fetal partial and intermediate atrioventricular septal defect

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of partial and intermediate atrioventricular septal defect (AVSD). Methods Ultrasound images of 11 cases of partial and intermediate AVSD confirmed by autopsy or postnatal echocardiography were retrospectively analyzed and the characteristics were summarized. Results Fetal echocardiography of seven cases of partial AVSD and four cases of intermediate AVSD at fourchamber view showed ostium primum atrial septal defect and the mitral and tricuspid valves attaching at the same level on the interventricular septum. Atrio-ventricular valves took on a straight, bar-liked appearance when closed and constituted a “T” shape with interventricular septum. One partial AVSD case showed left ventricle-right atrium canal. All intermediate AVSD cases showed upper ventricular septal defect. There were four cases associated with mitral reflux, one associated with mitral and tricuspid reflux and one with bilateral radius absence. Conclusions “T” shape image is of great clinical value in prenatal diagnosis of fetal partial and intermediate AVSD. The coronary sinus may lead to false positive diagnosis.