中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2013年
5期
398-401
,共4页
王峥%李军%朱永胜%孙益前%徐鹏%苏海砾%朱霆%郑敏娟%张建芳
王崢%李軍%硃永勝%孫益前%徐鵬%囌海礫%硃霆%鄭敏娟%張建芳
왕쟁%리군%주영성%손익전%서붕%소해력%주정%정민연%장건방
超声检查,产前%室间隔缺损%染色体异常
超聲檢查,產前%室間隔缺損%染色體異常
초성검사,산전%실간격결손%염색체이상
Ultrasonography,prenatal%Heart septal defect,ventricular%Chromosome aberrations
目的 探讨超声心动图在胎儿单纯性室间隔缺损(isolated ventricular septal defect,i-VSD)的产前诊断、病理分型及孕期和出生后随访中的临床价值.方法 对6145例胎儿超声检查中明确诊断为i-VSD的95例胎儿的心脏超声表现、病理解剖分型、遗传学检查及孕期和出生后超声随访1年的结果进行分析.结果 95例i-VSD彩色多普勒显像显示心室水平双向分流,缺损大小0.9~13.4 mm,平均(3.3±2.0)mm.其中膜周型60例(63.2%),肌型33例(34.7%),干下型1例(1.1%),多发1例(膜周型+肌型).32例进行染色体检查,其中正常28例,21-三体综合征3例(9.4%),18-三体综合征1例(3.1%).失访14例,活体出生50例,死亡5例,引产23例(尸检证实3例),未完成随访3例;50例出生后超声心动图复查与产前诊断结果一致,其中自然愈合13例(25%),手术2例,35例仍在随访观察.结论 胎儿期i-VSD以单发及膜周型最常见,部分可自然愈合,对遗传学异常也具有重要提示作用;超声心动图在i-VSD的产前诊断、随访观察和治疗方案制定等方面具有重要价值.
目的 探討超聲心動圖在胎兒單純性室間隔缺損(isolated ventricular septal defect,i-VSD)的產前診斷、病理分型及孕期和齣生後隨訪中的臨床價值.方法 對6145例胎兒超聲檢查中明確診斷為i-VSD的95例胎兒的心髒超聲錶現、病理解剖分型、遺傳學檢查及孕期和齣生後超聲隨訪1年的結果進行分析.結果 95例i-VSD綵色多普勒顯像顯示心室水平雙嚮分流,缺損大小0.9~13.4 mm,平均(3.3±2.0)mm.其中膜週型60例(63.2%),肌型33例(34.7%),榦下型1例(1.1%),多髮1例(膜週型+肌型).32例進行染色體檢查,其中正常28例,21-三體綜閤徵3例(9.4%),18-三體綜閤徵1例(3.1%).失訪14例,活體齣生50例,死亡5例,引產23例(尸檢證實3例),未完成隨訪3例;50例齣生後超聲心動圖複查與產前診斷結果一緻,其中自然愈閤13例(25%),手術2例,35例仍在隨訪觀察.結論 胎兒期i-VSD以單髮及膜週型最常見,部分可自然愈閤,對遺傳學異常也具有重要提示作用;超聲心動圖在i-VSD的產前診斷、隨訪觀察和治療方案製定等方麵具有重要價值.
목적 탐토초성심동도재태인단순성실간격결손(isolated ventricular septal defect,i-VSD)적산전진단、병리분형급잉기화출생후수방중적림상개치.방법 대6145례태인초성검사중명학진단위i-VSD적95례태인적심장초성표현、병리해부분형、유전학검사급잉기화출생후초성수방1년적결과진행분석.결과 95례i-VSD채색다보륵현상현시심실수평쌍향분류,결손대소0.9~13.4 mm,평균(3.3±2.0)mm.기중막주형60례(63.2%),기형33례(34.7%),간하형1례(1.1%),다발1례(막주형+기형).32례진행염색체검사,기중정상28례,21-삼체종합정3례(9.4%),18-삼체종합정1례(3.1%).실방14례,활체출생50례,사망5례,인산23례(시검증실3례),미완성수방3례;50례출생후초성심동도복사여산전진단결과일치,기중자연유합13례(25%),수술2례,35례잉재수방관찰.결론 태인기i-VSD이단발급막주형최상견,부분가자연유합,대유전학이상야구유중요제시작용;초성심동도재i-VSD적산전진단、수방관찰화치료방안제정등방면구유중요개치.
Objective To study clinical value of echocardiography in prenatal diagnosis,classification and follow-up after birth of isolated ventricular septal defect (i-VSD).Methods In 6145 fetuses undergoing fetal echocardiography,95 fetuses were diagnosed with i-VSD.The characteristics of fetal echocardiography,pathological classification of i-VSD,findings of genetic examination and follow-up of evolution of VSD were analyzed.Results In 95 fetuses with i-VSD,color Doppler flow imaging displayed bi-directional shunts at the ventricular level.Defect sizes ranged from 0.9 mm to 13.4 mm,averaged (3.3 ± 2.0)mm.There were 60 cases (63.2%) with perimembranous i-VSD,33 cases (34.7%) with muscular i-VSD,1 cases (1.1%)with subarterial i-VSD,1 cases (1.1%) with multiple i-VSD.Chromosome tests were performed successfully in 32 cases.Among these cases,there were 3 cases (9.4%) with Trisomy 21,1 case (3.12%)with Trisomy 18 and 28 cases with normal chromosomes.Among the cases,14 were lost to follow-up,50 were life labor,5 were stillbirth,23 were induced abortion and 3 had not finished follow-up.Among 50 cases of life labor,VSD were naturally closed in 13 cases (25%) prenatally or in one year after the birth.VSD were surgically repaired in 2 cases after birth.35 cases were still under follow-up.Conclusions Solitary and perimembranous i-VSDs were the most common types.Part of fetal i-VSDs naturally closed after birth.Prenatal i-VSD is a valuable suggestive clue for genetic abnormalities.Echocardiography has an important value in prenatal diagnosis,follow-up and treatment of VSD and may play an important role in predicting fetal genetic abnormality.