超声心动图不同切面诊断胎儿法洛四联症疾病谱的价值分析

目的应用超声心动图观察不同切面对胎儿法洛四联症(TOF)疾病谱的诊断价值。方法回顾性分析我院产前超声诊断为TOF的33例胎儿超声资料,并与产后超声、引产后病理对照,对胎儿四腔心切面(4CV)、左右心室流出道切面(VOTV)、三血管切面(3VV)、主动脉根部短轴切面(AR-SAV)的超声特征进行总结。结果32例胎儿经产后超声或引产后解剖证实为TOF,1例胎儿产后超声诊断为单纯室间隔缺损。4CV联合VOTV+3VV+AR-SAV对胎儿TOF的诊断准确率(96.97%)显著高于4CV+VOTV+3VV(90.90%)、4CV+3VV(84.85%)、4CV+VOTV(72.73%)、4CV+ARSAV(63.64%)、4CV(33.33%),差异均有统计学意义(均P<0.05)。结论胎儿TOF具有特征性超声表现,对肺动脉发育情况重点观察有利于胎儿TOF分型的判断。不同切面联合应用有助于提高TOF的诊断准确率。

Value of echocardiography with different sections in the diagnosis of fetal tetralogy of Fallot

Objective To explore the diagnostic value of prenatal echocardiography with different sections in tetralogy of Fallot.Methods The ultrasound data of 33 cases of tetralogy of fallot(TOF)were analyzed retrospectively,the results was compared with postpartum echocardiography and pathological anatomy,and the ultrasound image characteristics of fourchamber view(4CV),ventricular outflow tract section(VOTV),three-vessel section(3VT)and aortic root short-axis section(AR-SAV)were summarized.Results Thirty-two fetuses were confirmed as TOF by post-echocardiography or autopsy,and 1 fetus just simple venticular septal defect verified by postpartum echocardiography.The diagnostic rate of combination of 4CV,VOTV,3VT and AR-SAV for fetal TOF(96.97%)was significantly higher than that of 4CV+VOTV+3VT(90.90%),4CV+3VT(84.85%),4CV+VOTV(72.73%),4CV+AR-SAV(63.64%)and 4CV(33.33%),the difference were statistically significant(all P<0.05).Conclusion Fetal TOF have their echocardiographic features,the observation of pulmonary artery development is beneficial to the judgment of fetal TOF classification.Combined application of different sections helps to improve the accuracy of TOF prenatal diagnosis.