胎儿三血管气管平面在胎儿心室发育不良诊断中的价值

目的探讨胎儿三血管气管平面(3V T切面)在胎儿心室发育不良诊断中的价值.方法回顾性分析2003年4月-2005年1月在我院产前诊断门诊接受产前胎儿心脏超声筛查孕妇1212例,年龄20～44岁,孕周为16～38周.取胎儿心脏检查的常规6个标准切面,然后在四腔心切面的基础上缓慢平行向胎儿头侧移动探头即可显示胎儿上纵隔横切面,即三血管气管平面,再叠加彩色多普勒血流显像,观察各房室及大动脉血流分布和血流方向.结果 1212例胎儿超声心动图均获得满意的3V T切面,共检出胎儿心脏结构异常47例,其中心室发育不良11例(8例左心发育不良综合征和3例右心发育不良),年龄23～42岁,平均(29.8±5.7)岁,孕周20～39周,平均(26.7±5.6)周.10例心室发育不良均已引产并有5例尸检,尸检结论与超声检查完全一致,1例胎死宫内.结论胎儿3V T切面是一个简单、可靠的胎儿心脏大血管的筛查方法,能提高我们对涉及大动脉异常胎儿先心病的理解,是诊断胎儿心室发育不良的又一个重要切面.

Role of three vessels and trachea view in diagnosis of fetal ventricular hypoplasia

Objective To evaluate the value of three vessels and trachea(3V+ T view) view in diagnosing fetal ventricular hypoplasia.Methods One thousand two hundred and twelve pregnant women(20 to 44 years old) undergoing fetal ultrasound screening from April 2003 to January 2005 were enrolled in this retrospective study.The gestational week of these women ranged from 16 to 38 weeks.Six standard views of fetal heart and a 3V+T view were obtained to observe the distribution and direction of blood flow in the atriums,ventricles and big vessels.Results A satisfactory 3V+T view was obtained in each case.Of all the 1212 cases,47 cases(age from 23 to 42 years,20-39 gestational weeks) were diagnosed as fetal heart structural abnormity,including 11 fetal ventricular hypoplasia.Ten of these 11 cases had induced labor(termination of pregnancy) and the other one ended up in fetal death.Half of the 10 cases underwent autopsy after induction whose results were coherent with the ultrasonic diagnosis.Conclusion Three vessels and trachea view is a simple and reliable method for screening fetal cardiology anomalies and may become another important view in diagnosing fetal ventricular hypoplasia.