학술논문
胎儿完全型肺静脉异位引流产前超声诊断要点 / Prenatal ultrasonographic features of fetal total anomalous pulmonary venous connection
Document Type
Academic Journal
Author
Source
中华围产医学杂志 / Chinese Journal of Perinatal Medicine. 22(5):296-302
Subject
Language
Chinese
ISSN
1007-9408
Abstract
目的 探讨完全型肺静脉异位引流(total anomalous pulmonary venous connection,TAPVC)的产前超声声像图特点. 方法选取2013年6月至2018年6月于郑州大学第三附属医院行产前超声检查并最终获得手术证实的TAPVC病例41例作为研究对象,进行回顾性分析,总结产前超声声像图特点. 结果41例TAPVC胎儿中,生后手术证实心上型21例,心内型14例,心下型4例,混合型2例.TAPVC产前超声声像图特点:41例四腔心切面均显示左心房后壁光滑,肺静脉角消失;33例四腔心切面显示左心房与降主动脉间距增宽并可见肺静脉共腔;10例四腔心切面显示冠状静脉窦增大;27例三血管气管切面或上腹部横切面显示垂直静脉.41例TAPVC中7例合并血流梗阻,多普勒超声测量流速范围为0.76～1.25 m/s.41例均不合并其他心内结构异常. 结论产前超声检查时要细心观察肺静脉,发现肺静脉没有回流人左心房时要考虑肺静脉异位引流的可能.
Objective To investigate the prenatal ultrasonographic features of fetal total anomalous pulmonary venous connection (TAPVC).Methods Forty-one cases who received prenatal ultrasound examination and then were diagnosed with TAPVC by postnatal surgery at the Third Affiliated Hospital of Zhengzhou University from June 2013 to June 2018 were enrolled.Echocardiography findings of all cases were analyzed retrospectively,and the prenatal imaging features were summarized.Results Among all cases,21 were confirmed as supracardiac type,14 as intracardiac type,four as infracardiac type and two as mixed type after surgery.The echocardiographic features of TAPVC were as follows:all 41 cases showed smooth posterior wall of left atrium without visible part of pulmonary venous connected to the left atrium in the-four chamber view;in 33 cases,the space between left atrium and descending aorta was widened and the pulmonary venous confluence was observed in the four-chamber view;ten cases showed a dilated coronary sinus in the four-chamber view and 27 cases showed vertical vein in the three vessels and trachea or the upper abdomen view.None of the 41 cases was complicated by other structural intracardiac abnormalities.However,seven cases were complicated by obstruction of blood flow,and the blood flow velocity measured by Doppler ultrasound was 0.76 m/s to 1.25 m/s.Conclusions Blood flow in pulmonary veins should be carefully observed in prenatal ultrasonography,and anomalous pulmonary venous connection should be considered when pulmonary veins do not connect to the left atrium.
Objective To investigate the prenatal ultrasonographic features of fetal total anomalous pulmonary venous connection (TAPVC).Methods Forty-one cases who received prenatal ultrasound examination and then were diagnosed with TAPVC by postnatal surgery at the Third Affiliated Hospital of Zhengzhou University from June 2013 to June 2018 were enrolled.Echocardiography findings of all cases were analyzed retrospectively,and the prenatal imaging features were summarized.Results Among all cases,21 were confirmed as supracardiac type,14 as intracardiac type,four as infracardiac type and two as mixed type after surgery.The echocardiographic features of TAPVC were as follows:all 41 cases showed smooth posterior wall of left atrium without visible part of pulmonary venous connected to the left atrium in the-four chamber view;in 33 cases,the space between left atrium and descending aorta was widened and the pulmonary venous confluence was observed in the four-chamber view;ten cases showed a dilated coronary sinus in the four-chamber view and 27 cases showed vertical vein in the three vessels and trachea or the upper abdomen view.None of the 41 cases was complicated by other structural intracardiac abnormalities.However,seven cases were complicated by obstruction of blood flow,and the blood flow velocity measured by Doppler ultrasound was 0.76 m/s to 1.25 m/s.Conclusions Blood flow in pulmonary veins should be carefully observed in prenatal ultrasonography,and anomalous pulmonary venous connection should be considered when pulmonary veins do not connect to the left atrium.