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目的探讨胎儿三血管气管平面的声像图特点及其筛查胎儿先天性心脏病的价值。方法回顾性分析2003年4月至2005年4月1212例接受产前胎儿心脏超声筛查孕妇资料,取胎儿心脏检查的常规6个标准切面,然后在四腔心切面的基础上缓慢平行向胎儿头侧移动探头即可显示上纵隔横切面,即三血管气管平面,再叠加彩色多普勒血流显像,观察各房室及大动脉血流分布和血流方向。结果1212例胎儿超声心动图检出胎儿心脏结构异常47例,22例合并心外畸形。33例在本院引产,20例尸检,其中18例尸检与产前超声诊断相符,1例单心房单心室并大动脉位置正常误诊为单心房单心室并大动脉转位,1例单心房单心室并永存动脉干误诊为完全性心内膜垫缺损并永存动脉干。15例胎儿抽脐带血检查染色体,3例染色体异常。结论三血管气管平面在筛查胎儿大动脉和心室流出道异常的先天性心脏病中有重要作用。
Objective To investigate the characteristics of fetal trigeminal tracheal plane and its value in screening fetal congenital heart disease. Methods The data of 1212 pregnant women undergoing prenatal fetal cardiac ultrasound screening from April 2003 to April 2005 were retrospectively analyzed. Six standard sections of fetuses underwent routine cardiac examination were retrospectively analyzed. On the basis of four-chamber coronal sections, Head-side mobile probe to display the transverse section of the mediastinum, the three-vessel tracheal plane, and then superimposed color Doppler flow imaging to observe the atrioventricular and aortic flow distribution and blood flow direction. Results 1212 cases of fetal echocardiography were detected in 47 cases of fetal cardiac structural abnormalities, 22 cases of extra-cardiac malformations. Totally 33 cases were induced by labor in our hospital and 20 cases were autopsied. Among them, 18 cases of autopsy were consistent with prenatal diagnosis. One case of single atrial and venous aorta was misdiagnosed as single atrium and single aorta and transposition of aorta. Perpetuated arterial misdiagnosed as complete destruction of the endocardial pad and permanent dry arteries. Fifteen fetuses had umbilical cord blood for chromosome examination and three chromosomal abnormalities. Conclusion The trigeminal tracheal plane plays an important role in the screening of congenital heart disease in which the fetal aorta and ventricular outflow tract are abnormal.