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胎儿完全性大动脉转位产前超声诊断

张一休 孟华 鲁嘉 赵大春 欧阳云淑 姜玉新 戴晴

张一休, 孟华, 鲁嘉, 赵大春, 欧阳云淑, 姜玉新, 戴晴. 胎儿完全性大动脉转位产前超声诊断[J]. 协和医学杂志, 2014, 5(1): 64-67. doi: 10.3969/j.issn.1674-9081.2014.01.015
引用本文: 张一休, 孟华, 鲁嘉, 赵大春, 欧阳云淑, 姜玉新, 戴晴. 胎儿完全性大动脉转位产前超声诊断[J]. 协和医学杂志, 2014, 5(1): 64-67. doi: 10.3969/j.issn.1674-9081.2014.01.015
Yi-xiu ZHANG, Hua MENG, Jia LU, Da-chun ZHAO, Yun-shu OUYANG, Yu-xin JIANG, Qing DAI. Application of Ultrasound in the Prenatal Diagnosis of Fetal Transposition of the Great Arteries[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(1): 64-67. doi: 10.3969/j.issn.1674-9081.2014.01.015
Citation: Yi-xiu ZHANG, Hua MENG, Jia LU, Da-chun ZHAO, Yun-shu OUYANG, Yu-xin JIANG, Qing DAI. Application of Ultrasound in the Prenatal Diagnosis of Fetal Transposition of the Great Arteries[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(1): 64-67. doi: 10.3969/j.issn.1674-9081.2014.01.015

胎儿完全性大动脉转位产前超声诊断

doi: 10.3969/j.issn.1674-9081.2014.01.015
详细信息
    通讯作者:

    孟华 电话:010-69155494, E-mail:menghua_pumch@yahoo.com

  • 中图分类号: R445.1;R714.53

Application of Ultrasound in the Prenatal Diagnosis of Fetal Transposition of the Great Arteries

More Information
  • 摘要:   目的  探讨超声对胎儿完全性大动脉转位的诊断价值。  方法  回顾性分析2010年3月至2013年7月北京协和医院4例胎儿完全性大动脉转位的产前超声表现, 并与病理结果进行比较。  结果  4例完全性大动脉转位胎儿中, 3例四腔心切面正常, 1例可见室间隔缺损。左室及右室流出道切面4例胎儿可见心室与大动脉连接关系异常, 2例可见室间隔膜部缺损。三血管气管切面4例均仅可见2条血管。  结论  完全性大动脉转位具有特征性超声表现, 重点观察心室流出道切面及三血管气管切面有助于产前正确诊断。
  • 图  1  例4,四腔心切面基本正常,左右心对称,房室关系正确,可见肺静脉与左房相连,未见明显室间隔缺损

    图  2  例1,左室流出道切面见肺动脉由左心室发出,并发出左右肺动脉分支

    图  3  例3,三血管切面见主动脉及其右侧上腔静脉,肺动脉未显示

    图  4  例2,大血管纵切面可见两条大血管平行走行

    图  5  例4,心脏解剖标本示主动脉从右心室发出,内径较细;肺动脉从左心室发出,与主动脉平行

    表  1  4例完全性大动脉转位胎儿产前超声表现

    序号 孕妇年龄
    (岁)
    月经
    孕周
    胎儿
    性别
    胎儿心脏超声异常表现 合并心内
    异常
    合并心外
    异常
    随访
    1 31 22w+1 正常 肺动脉由左
    室发出
    主动脉由右
    室发出
    仅见两条
    血管
    主动脉肺动
    脉平行
    室缺0.1 cm 引产
    2 30 21w+0 正常 肺动脉由左
    室发出
    主动脉由右
    室发出
    仅见两条
    血管
    主动脉肺动
    脉平行
    引产,未行病理
    3 34 26w+0 室缺1.0 cm 肺动脉由左
    室发出,室
    缺1.0 cm
    主动脉由右
    室发出
    仅见两条
    血管
    主动脉肺动
    脉平行
    室缺1.0 cm 引产
    4 31 22w+5 正常 肺动脉由左
    室发出,膜
    周部室缺
    0.39 cm
    主动脉由右
    室发出
    主动脉内径
    0.27 cm
    仅见两条
    血管,主
    动脉弓缩
    主动脉肺动
    脉平行
    室缺0.4 cm
    主动脉弓缩窄
    引产
    下载: 导出CSV
  • [1] Hoffman JI, Kaplan S. The incidence of congenital heart disease[J].J Am Coll Cardiol, 2002, 39:1890-1900. doi:  10.1016/S0735-1097(02)01886-7
    [2] Jouannic JM, Gavard L, Fermont L, et al. Sensitivity and specificity of prenatal features of physiological shunts to predict neonatal clinical status in transposition of the great arteries[J]. Circulation, 2004, 110:1743-1746. doi:  10.1161/01.CIR.0000144141.18560.CF
    [3] Garne E, Stoll C, Clementi M, et al. Evaluation of prenatal diagnosis of congenital heart diseases by ultrasound:experience from 20 European registries[J]. Ultrasound Obstet Gynecol, 2001, 17:386-391. doi:  10.1046/j.1469-0705.2001.00385.x
    [4] Ishii Y, Inamura N, Kawazu Y, et al. 'I-shaped' sign in the upper mediastinum:a novel potential marker for antenatal diagnosis of d-transposition of the great arteries[J].Ultrasound Obstet Gynecol, 2013, 41:667-671. doi:  10.1002/uog.12312
    [5] Shih JC, Shyu MK, Su YN, et al. 'Big-eyed frog' sign on spatiotemporal image correlation (STIC) in the antenatal diagnosis of transposition of the great arteries[J]. Ultrasound Obstet Gynecol, 2008, 32:762-768. doi:  10.1002/uog.5369
    [6] Allan L. Technique of fetal echocardiography[J]. Pediatr Cardiol, 2004, 25:223-233. doi:  10.1007/s00246-003-0588-y
    [7] Oggè G, Gaglioti P, Maccanti S, et al. Prenatal screening for congenital heart disease with four-chamber and outflow-tract views:a multicenter study[J]. Ultrasound Obstet Gynecol, 2006, 28:779-784. doi:  10.1002/uog.3830
    [8] Chaoui R. The four-chamber view:four reasons why it seems to fail in screening for cardiac abnormalities and suggestions to improve detection rate[J]. Ultrasound Obstet Gynecol, 2003, 2:3-10. http://www.ncbi.nlm.nih.gov/pubmed/12858294
    [9] Bartlett JM, Wypij D, Bellinger DC, et al. Effect of prenatal diagnosis on outcomes in D-transposition of the great arteries[J]. Pediatrics, 2004, 113:e335-e340. doi:  10.1542/peds.113.4.e335
    [10] Gonçalves LF, Espinoza J, Romero R, et al. A systematic approach to prenatal diagnosis of transposition of the great arteries using 4-dimensional ultrasonography with spatiotemporal image correlation[J]. J Ultrasound Med, 2004, 23:1225-1231. doi:  10.7863/jum.2004.23.9.1225
    [11] Viñals F, Ascenzo R, Poblete P, et al. Simple approach to prenatal diagnosis of transposition of the great arteries[J]. Ultrasound Obstet Gynecol, 2006, 28:22-25. doi:  10.1002/uog.2821
    [12] DeVore GR, Polanco B, Sklansky MS, et al. The 'spin' technique:a new method for examination of the fetal outflow tracts using three-dimensional ultrasound[J]. Ultrasound Obstet Gynecol, 2004, 24:72-82. doi:  10.1002/uog.1085
    [13] Yagel S, Arbel R, Anteby EY, et al. The three vessels and trachea view (3VT) in fetal cardiac scanning[J]. Ultrasound Obstet Gynecol, 2002, 20:340-345. doi:  10.1046/j.1469-0705.2002.00801.x
    [14] Gardiner H, Chaoui R. The fetal three-vessel and tracheal view revisited[J/OL]. Semin Fetal Neonatal Med, 2013[2013-09-04].http://dx.doi.org/10.1016/j.siny.2013.01.007.
    [15] Moene RJ, Ottenkamp J, Oppenheimer-Dekker A, et al. Transposition of the great arteries and narrowing of the aortic arch. Emphasis on right ventricular characteristics[J]. Br Heart J, 1985, 53:58-63. doi:  10.1136/hrt.53.1.58
    [16] Wimalasundera RC, Gardiner HM. Congenital heart disease and aneuploidy[J]. Prenat Diagn, 2004, 24:1116-1122. doi:  10.1002/pd.1068
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出版历程
  • 收稿日期:  2013-10-21
  • 刊出日期:  2014-01-30

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