胎儿超声心动图在诊断永存左上腔静脉中的应用

目的 总结永存左上腔静脉胎儿超声心动图特征及临床意义.方法 对2008年5月至2011年1月在我院诊断为永存左上腔静脉的33例胎儿超声心动图表现进行总结分析,并与引产后病理或产后超声心动图诊断结果进行对照分析,总结永存左上腔静脉胎儿超声心动图特征及临床价值.结果 33例永存左上腔静脉胎儿中引产后病理或产后超声心动图证实32例,超声表现为:四腔观可见扩张的冠状静脉窦,三血管观在肺动脉左侧可见一圆形血管回声,为永存左上腔静脉,同时可见右上腔静脉变细,追踪走行可见其与冠状静脉窦相连续.其中18例为单发畸形(18/32,56.25%),14例合并其他畸形(7例合并心内畸形,2例合并心外畸形,5例同时合并心内和心外畸形).胎儿超声心动图将内脏反位综合征合并完全型房室间隔缺损误诊为同时合并永存左上腔静脉1例.结论 胎儿超声心动图是诊断永存左上腔静脉的可靠方法.永存左上腔静脉常合并其他畸形,产前超声发现永存左上腔静脉需进一步检查以排除其他合并畸形.

The use of fetal echocardiography in diagnosis of persistent left superior vena cava

Objective To summarize the echocardiographic characteristics and clinical significance of prenatal diagnosis of persistent left superior vena cava(PLSVC).Methods Images of thirty-three fetuses with PLSVC diagnosed by fetal echocardiography between May,2008 to January,2011 in our department were reviewed.All the echo results were compared with pathology or postnatal echocardiography.Echocardiographic characteristics and clinical significance of prenatal diagnosis of PLSVC were summarized.Results Among the 33 cases of PLSVC diagnosed by fetal echocardiography,32 cases were confirmed by pathology or postnatal echocardiograpy and 1 case was misdiagnosed.The echocardiographic features of PLSVC were a dilated coronary sinus in the four chamber view,an additional vessel on the left side of the pulmonary trunk in the three vessels view and the drainage of the PLSVC to the coronary sinus.Among the 32 cases of PLSVC,18 cases were isolated and the other 14 cases were all in association with other anomalies,including:7 cases with intracardiac abnormalities,2 cases with extracardiac anomalies and 5 cases with both intracardiac and extracardiac lesions.Conclusions Fetal echocardiography plays an important role in diagnosing PLSVC prenatally.Since PLSVC often accompanies with other anomalies,the identification of PLSVC might indicate a thorough examination to identify additional intracardiac and extracardiac lesions.