郑州大学学报（医学版）
鄭州大學學報（醫學版）
정주대학학보（의학판）
JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES)
2013年
6期
776-779,780
,共5页
永存左侧上腔静脉%心脏畸形%心房异构%产前诊断
永存左側上腔靜脈%心髒畸形%心房異構%產前診斷
영존좌측상강정맥%심장기형%심방이구%산전진단
persistent left superior vena cava%heart defect%atrial isomerism%prenatal diagnosis
目的：分析胎儿永存左侧上腔静脉（ PLSVC）的影像特征及其伴随心内、心外畸形的特点。方法：回顾分析25737例胎儿系统超声及超声心动图影像资料。三血管切面发现“第四条血管”时，进一步获得其长轴切面以明确诊断。结果：产前超声诊断胎儿PLSVC 67例，表现为肺动脉左侧的“第四条血管”，长轴切面显示该血管血流经冠状静脉窦流入心房。 PLSVC胎儿与非PLSVC胎儿的心内结构异常发生率比较，差异有统计学意义（χ2校正＝955．968，P＜0．001），且2组胎儿的静脉异常发生率比较，差异有统计学意义（P＜0．001）。心脏畸形胎儿中，PLS-VC胎儿与非PLSVC胎儿的心房异构发生率比较，差异有统计学意义（χ2校正＝84．223， P＜0．001）。在PLSVC合并心脏畸形胎儿中，心房异构者心脏畸形以房室间隔缺损、右室双出口为多；非心房异构者心脏畸形以室间隔缺损、圆锥动脉干畸形及主动脉弓缩窄为多。结论：三血管及腔静脉长轴切面是诊断PLSVC的最佳切面。 PLSVC胎儿易合并心脏畸形，特别是心房异构综合征及血管发育异常。
目的：分析胎兒永存左側上腔靜脈（ PLSVC）的影像特徵及其伴隨心內、心外畸形的特點。方法：迴顧分析25737例胎兒繫統超聲及超聲心動圖影像資料。三血管切麵髮現“第四條血管”時，進一步穫得其長軸切麵以明確診斷。結果：產前超聲診斷胎兒PLSVC 67例，錶現為肺動脈左側的“第四條血管”，長軸切麵顯示該血管血流經冠狀靜脈竇流入心房。 PLSVC胎兒與非PLSVC胎兒的心內結構異常髮生率比較，差異有統計學意義（χ2校正＝955．968，P＜0．001），且2組胎兒的靜脈異常髮生率比較，差異有統計學意義（P＜0．001）。心髒畸形胎兒中，PLS-VC胎兒與非PLSVC胎兒的心房異構髮生率比較，差異有統計學意義（χ2校正＝84．223， P＜0．001）。在PLSVC閤併心髒畸形胎兒中，心房異構者心髒畸形以房室間隔缺損、右室雙齣口為多；非心房異構者心髒畸形以室間隔缺損、圓錐動脈榦畸形及主動脈弓縮窄為多。結論：三血管及腔靜脈長軸切麵是診斷PLSVC的最佳切麵。 PLSVC胎兒易閤併心髒畸形，特彆是心房異構綜閤徵及血管髮育異常。
목적：분석태인영존좌측상강정맥（ PLSVC）적영상특정급기반수심내、심외기형적특점。방법：회고분석25737례태인계통초성급초성심동도영상자료。삼혈관절면발현“제사조혈관”시，진일보획득기장축절면이명학진단。결과：산전초성진단태인PLSVC 67례，표현위폐동맥좌측적“제사조혈관”，장축절면현시해혈관혈류경관상정맥두류입심방。 PLSVC태인여비PLSVC태인적심내결구이상발생솔비교，차이유통계학의의（χ2교정＝955．968，P＜0．001），차2조태인적정맥이상발생솔비교，차이유통계학의의（P＜0．001）。심장기형태인중，PLS-VC태인여비PLSVC태인적심방이구발생솔비교，차이유통계학의의（χ2교정＝84．223， P＜0．001）。재PLSVC합병심장기형태인중，심방이구자심장기형이방실간격결손、우실쌍출구위다；비심방이구자심장기형이실간격결손、원추동맥간기형급주동맥궁축착위다。결론：삼혈관급강정맥장축절면시진단PLSVC적최가절면。 PLSVC태인역합병심장기형，특별시심방이구종합정급혈관발육이상。
Aim:To analyze sonographic features of persistent left superior vena cava ( PLSVC) of fetuses and its car-diac and extracardiac anomalies .Methods:A total of 25 737 sonographic and echocardiographic data of fetuses were retro-spectively studied .When a supernumerary vessel left of the pulmonary trunk showed on three-vessel view , it would be scaned on long-axis view.Results:A total of 67 cases of PLSVC were detected , which was showed as an additional vessel identified to the left pulmonary artery on three-vessel view and drainage via the coronary sinus into atrium on long-axis view. The congenital heart defect rates were significantly different between fetuses with and without PLSVC (χ2adjust =955.968,P<0.001)and the anomalous connection of vein rates were also significantly different (P<0.001).Between fetuses with and without PLSVC the atrial isomerism rates were also different (χ2adjust=84.223, P<0.001).Among fetuses with PLSVC, the most common cardiac malformations in those with atrial isomerism were atrioventricular septal defect and double right ventri -cle outlets, while the common most congenital heart defects in those without atrial isomerism were ventricular septal defect , conotruncal defect and coarction .Conclusion:The three-vessel view and long-axis vein view are the best diagnostic planes of PLSVC.PLSVC has greater prevalence in fetuses with congenital heart defects , especially with atrial isomerism and ve-nous anomaly cases .
