| 摘要: |
| 目的 探讨超声心动图对胎儿法洛四联症(Tetralogy of Fallot，TOF）合并肺动脉狭窄(TOF/PS)、TOF合并肺动脉闭锁(TOF/PA)、TOF合并肺动脉瓣缺如（TOF/PV-AB）的诊断价值。方法 回顾性分析2016年1月至2019年8月，我院产前超声诊断为TOF的33例胎儿超声，并与产后超声、引产后病理对照，总结胎儿TOF超声特征。结果33例胎儿TOF中，TOF/PS 22例，TOF/PA 7例，TOF/PV-AB 4例。三者超声均具有主动脉瓣下室间隔缺损和主动脉骑跨的特征，其不同之处在于肺动脉发育情况。在四腔心切面（4CV）基础上联合左、右室流出道切面（VOTV）、三血管切面（3VT）及主动脉根部短轴切面（AR-SAV）对胎儿TOF的诊断率（96．97％）显著高于4CV +VOTV + 3VT(90.90％)、4CV+3VT(84.85％)、4CV +VOTV（72.73％）、4CV +AR-SAV（63.64％ ）、4CV（33.33％），差异具有统计学意义 (P <0.05)。结论 胎儿TOF具有特征性超声表现，对肺动脉发育情况重点观察有利于胎儿TOF分型的判断。同时不同切面联合应用有助于提高TOF诊断的准确率，为预后评估和出生后及时有效的干预提供重要的诊断依据。 |
| 关键词: 超声心动图 胎儿 法洛四联症 产前诊断 |
| DOI： |
| 投稿时间：2019-12-17修订日期：2020-01-13 |
| 基金项目:重庆市社会事业与民生保障科技创新专项重点研发项目（cstc2017shms-zdyfX0017）；陆军军医大学第二附属医院军事临床医学创新技术项目（2018JSLC0032） |
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| Prenatal echocardiographic diagnosis of fetal tetralogy of Fallot |
| DENG Xi,XIA Hongmei,JIANG Huan,LAI Xiaoyue,JIANG Yan,TANG Qi,GAO Yunhua,XU Yali |
| (Department of Ultrasound，the Second Affiliated Hospital of Army Medical University) |
| Abstract: |
| Objective To explore the diagnostic value of prenatal echocardiographic in Tetralogy of Fallot (TOF) with pulmonary stenosis (TOF/PS),TOF with pulmonary atresia (TOF/PA) and TOF with absence of pulmonary valve(TOF/PV-AB). Methods The data of 33 fetuses diagnosed as tetralogy of fallot were analyzed retrospectively. The results of prenatal echocardiography were compared with postpartum echocardiography and pathological anatomy after induction of labor. Results Among the 33 cases of fetal TOF, there were 22 cases of TOF/PS, 7 cases of TOF/PA, and 4 cases of TOF/PV-AB.All three sonography had the characteristics of subaortic ventricular septal defect (VSD) and the aortic root straddling the interventricular septum (IVS),the difference lies in the development of the pulmonary artery. On the basis of four-chamber view (4CV) and ventricular outflow tract section (VOT), three-vessel section (3VT) and aortic root short-axis section (AR-SAV), the diagnostic rate of fetal TOF (96.97%) were significantly higher than that of 4CV+ VOTV +3VT (90.90%), 4CV+3VT(84.85%), 4CV+ VOTV (72.73%), 4CV+ AR-SAV (63.64%), and 4CV (33.33%) (P <0.05). Conclusion Fetal TOF have their echocardiographic features. The observation of pulmonary artery development is beneficial to the judgment of fetal TOF classification.Combined application of different sections helps to improve the accuracy of TOF prenatal diagnosis, which is expected to provide important clinical basis for prognosis evaluation and effective intervention after birth. |
| Key words: Echocardiography Fetus Tetralogy of Fallo Prenatal diagnosis |
