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目的分析54例胎儿心脏畸形的彩色多普勒超声表现,以期提高胎儿心脏畸形的早期检出率。方法行胎儿三维超声筛查或孕中晚期普通超声检查发现胎儿心脏畸形的孕妇54例,每例均运用超声探头从不同切面不同角度对胎儿心脏进行全方位观察,其中四腔心切面、大动脉短轴切面、左右室流出道切面及主动脉弓切面和三血管-气管切面是重点,但对于复杂畸形者则不能完全显示每一标准切面,分析各类畸形在不同切面的不同表现。结果心内膜垫缺损8例,法洛四联症7例,单心房3例,单心室4例,永存动脉干3例,大动脉转位4例,单纯室间隔缺损3例,肺动脉狭窄或闭锁5例,主动脉弓离断或缩窄各1例,三尖瓣下移3例,右室双出口2例,误诊2例,其他畸形8例。结论四腔心切面、大动脉短轴切面、主动脉弓切面和三血管-气管切面是彩色多普勒超声诊断胎儿心脏畸形的最主要切面,可早期筛查出绝大部分胎儿心脏畸形。而采用高频探头、图像的缩放功能以及注重右室流出道-肺动脉长轴切面和静脉-心房连接关系的扫查是避免漏诊或不全面诊断的重要因素。
Objective To analyze the color Doppler sonography of 54 cases of fetal heart malformations in order to improve the early detection rate of fetal heart malformations. Methods Forty-four pregnant women with fetal heart malformations were examined by three-dimensional ultrasound screening of fetus or common ultrasound in the second trimester. All cases were observed with fetal heart from different angles and different angles. The four-chamber coronal section, Axial section, right and left ventricular outflow tract section and the aortic arch section and tri-vascular-tracheal section is the focus, but for complex deformity can not fully display each standard section, analysis of various deformities in different sections of different performance. Results There were 8 cases of endocardial cushion defect, 7 cases of tetralogy of Fallot, 3 cases of single atrium, 4 cases of single ventricle, 3 cases of permanent arterial trunk, 4 cases of aortic transposition, 3 cases of simple ventricular septal defect, pulmonary stenosis or atresia 5 cases, 1 case of aortic arch separation or narrowing, 3 cases of tricuspid regurgitation, 2 cases of right ventricular outlet, misdiagnosis in 2 cases and other deformities in 8 cases. Conclusions The four-chamber echocardiography, the short-axis view of the aorta, the aortic arch and the three-vessel-tracheal section are the most important aspects for the diagnosis of fetal heart deformity by color Doppler ultrasonography. Early fetal heart deformity can be screened out at an early stage. The use of high-frequency probes, image scaling, and emphasis on right ventricular outflow tract - pulmonary artery long axis and venous - atrial connection scan to avoid missed diagnosis or incomplete diagnosis of an important factor.