孕11~13+6周心脏畸形胎儿四腔心切面声像图特征

目的 观察孕11~13⁺⁶周心脏畸形胎儿四腔心切面声像图特征，探讨其在早孕期筛查中的价值。方法 回顾性分析24胎经病理、中孕期胎儿超声心动图检查或出生后随访证实的11~13⁺⁶周心脏复杂畸形胎儿心脏四腔心切面超声声像图特征和颈项透明层（NT）厚度。结果 24胎心脏畸形胎儿早孕期四腔心切面表现：①6胎正常，可见2束比例相当的心室流入道血流；②3胎表现为比例失调的2束血流；③5胎仅显示1束房室瓣血流，于心室水平再分为左右2束血流；④5胎显示1束房室瓣血流，于心室水平无分叉；⑤5胎表现为室间隔过隔血流。24胎中，16胎（16/24，66.67%）NT增厚，8胎（8/24，33.33%）NT正常。结论 11~13⁺⁶周四腔心切面超声表现对筛查胎儿心脏畸形具有一定价值，有望将部分心脏畸形的检查时间窗由中孕期提前至早孕期。

Ultrasonic features of four chamber heart view in 11-13+6 weeks fetuses with heart malformation

Objective To observe the ultrasonic features of four chamber heart (4CH) view in 11-13⁺⁶ weeks fetuses with congenital heart malformations,and to explore their value in fetal malformation screening in the first trimester. Methods Totally 24 fetuses with congenital heart malformations confirmed with pathology or echocardiography in the second trimester or postpartum follow-up were enrolled, and the ultrasonic imaging features and nuchal translucency (NT) value in 11-13⁺⁶ weeks were retrospectively analyzed. Results In all 24 fetuses, 18 fetuses (18/24, 75.00%) were abnormal in 4CH views in the first trimester. There were 5 different ultrasonic imaging features of in 4CH views in the first trimester of 24 fetuses, including normal view in 6 fetuses showing 2 proportional ventricular inflows, 2 disproportionate ventricular inflows in 3 fetuses, the initially 1 shared inflows, but 2 flows in the ventricular level in 5 fetuses, the singular inflows and no bifurcate at the ventricular level in 5 fetuses, the transseptal flows in 5 fetuses. Sixteen fetuses (16/24, 66.67%) were found with increased NT, and 8 (8/24, 33.33%) with normal NT. Conclusion Ultrasonic features of 4CH view in 11-13⁺⁶ weeks are of certain value in detection of fetal heart malformations, which are expected to advance the inspect period of some heart defects from the second trimester to the first trimester.