CAJ | 학술논문

目的探讨超声心动图检测胎儿心脏强回声结构(intracardiac hyperechogenic focus,ICEF)及对ICEF胎儿心功能评价的临床意义.方法采用胎儿超声心动图对1291例孕22～40周胎儿进行检测,对检出的ICEF胎儿测量心脏大小及室壁厚度,定量主动脉瓣口、肺动脉瓣口、房室瓣口血流速度,测量房室瓣环舒张早期、舒张晚期及收缩期运动的峰值速度(Em、Am、Sm);随机选择128例正常胎儿作为对照组并测量相关参数;比较单纯ICEF胎儿与正常胎儿间的心脏收缩及舒张功能参数.结果共检出ICEF胎儿448例,检出率34.7%(448/1291),其中伴先天性心血管畸形24例(5.4%),轻度三尖瓣反流24例(5.4%),染色体异常1例(0.22%).399例单纯ICEF胎儿与正常胎儿之间比较,二维及M型超声心动图所测心脏大小及室壁厚度等参数差异均无统计学意义(P＞0.05),单纯性ICEF胎儿与正常胎儿之间比较,主动脉瓣口、肺动脉瓣口、房室瓣口血流流速曲线及房室瓣环运动速度参数差异均无统计学意义(P＞0.05).结论单纯性的ICEF胎儿伴发染色体异常的几率较低,并不伴明显血流动力学改变.
목적 탐토초성심동도검측태인심장강회성결구(intracardiac hyperechogenic focus,ICEF)급대ICEF태인심공능평개적림상의의.방법 채용태인초성심동도대1291례잉22～40주태인진행검측,대검출적ICEF태인측량심장대소급실벽후도,정량주동맥판구、폐동맥판구、방실판구혈류속도,측량방실판배서장조기、서장만기급수축기운동적봉치속도(Em、Am、Sm);수궤선택128례정상태인작위대조조병측량상관삼수;비교단순ICEF태인여정상태인간적심장수축급서장공능삼수.결과 공검출ICEF태인448례,검출솔34.7%(448/1291),기중반선천성심혈관기형24례(5.4%),경도삼첨판반류24례(5.4%),염색체이상1례(0.22%).399례단순ICEF태인여정상태인지간비교,이유급M형초성심동도소측심장대소급실벽후도등삼수차이균무통계학의의(P＞0.05),단순성ICEF태인여정상태인지간비교,주동맥판구、폐동맥판구、방실판구혈류류속곡선급방실판배운동속도삼수차이균무통계학의의(P＞0.05).결론 단순성적ICEF태인반발염색체이상적궤솔교저,병불반명현혈류동역학개변.
Objective To evaluate the clinical significance and cardiac function of fetuses with intracardiac hyperechogenic focus(ICEF) by fetal echocardiography. Methods Fetal echocardiograms were performed on 1291 fetuses for evaluation of fetal heart structures and rhythms. Echocardiographic characteristics of ICEF were investigated. Fetal systolic and diastolic functions of 399 fetuses with an isolated ICEF were compared with 128 normal fetuses using conventional two-dimensional, M-mode, pulsed Doppler echocardiography and myocardial Doppler tissue imaging(DTI). Results The prevalence of ICEF was 34. 7% (448/1291). Twenty-four(5.4%) cases were found with cardiovascular malformations. There was 1 (0.22%) case of ICEF fetus associated with chromosomal abnormality (trisomy 21 ). Comprehensive fetal echocardiographic data analysis showed no significant differences in heart dimensions, global cardiac functions,and myocardial performances in the two groups( P ＞0.05). Conclusions An isolated ICEF in the fetal heart is not associated with increased risk for chromosome abnormalities. Fetuses with ICEF do not indicate impaired left ventricular systolic or diastolic function, therefore having no hemodynamic significance.