超声五平面法筛查胎儿心脏畸形的诊断价值

目的:探讨超声五平面法筛查胎儿先天性心脏畸形的可行性及诊断价值。方法:对3340例产前超声检查者常规观察胎儿心脏五个平面,即胃泡、四腔心、左室流出道、右室流出道、三血管-气管平面,发现异常者做超声心动图检查。将我院超声检查结果与分娩后尸检和新生儿心脏彩色多普勒检查结果进行对照分析,旨在探讨超声五平面法筛查胎儿心脏畸形的临床价值。结果:超声诊断心脏畸形12例,其中7例查胎儿心动图并引产尸检证实,另5例出生后超声心动图复查证实。误诊1例,将法洛四联症误诊为单心室合并永存动脉干畸形。漏诊室间隔缺损3例,房间隔缺损2例,动脉导管未闭1例。结论:超声五平面法可以筛查绝大部分的胎儿先天性心脏畸形,包括大血管畸形,但对于室间隔或房间隔上小的缺损容易漏诊。

The diagnostic value of five-plane-ultrasound to screen fetus cardiac anomalies

Objective：To evaluate the feasibility and diagnostic value of five-plane-ultrasound to screen fetus cardiac anomalies.Methods：Routine five planes were observed by antepartum ultrasound in 3340 fetuses： gastriole,quadri-cavity hearts,left chamber effluent tract,right chamber effluent tract,and tri-vessel-trachea.Echocardiography was carried out in case of abnormities.The results of ultrasound,autopsy after parturition and color Doppler were compared with each other in our analysis to investigate the value of five-plane-ultrasound to screen fetus cardiac anomalies.Results：Twelve cardiac abnormalities were found,among which 7 were proved by cardiotocogram and autopsy by induced abortion,the other 5 cases were proved by echocardiogram after labor.1 case was misdiagnosed,in which Fallot＇s disease was misdiagnosed to be single cardiac ventricle with truncus arteriosus persistens.3 cases with interventricular septal defect, 2 cases with atrial septal defect,1 case with arterial were misdiagnosed.Conclusion：Five-plane ultrasound can be used to screen most of the fetus congenital malformation of heart,including great vessel abnormalities.However,small interventricular septum and atrial septum defect are easily misdiagnosed.