CAJ | 학술논문

目的分析胎儿下腔静脉离断的产前超声特点及其与异构畸形的关系,旨在提高胎儿异构畸形的产前诊断率. 方法对2010年1月至2013年12月在北京大学人民医院产前检查或因可疑胎儿畸形转入本院会诊的孕妇,进行常规胎儿超声心动图检查,并常规扫查胎儿腹腔横切面.对腹腔横切面表现为奇静脉增宽、下腔静脉消失的胎儿,利用时间-空间关联成像技术进一步明确是否有下腔静脉离断,根据是否合并有心脏结构异常分为复杂性下腔静脉离断和孤立性下腔静脉离断,对继续妊娠者随访至生后,新生儿行超声心动图检查,对终止妊娠者引产胎儿行尸体解剖. 结果产前共诊断下腔静脉离断12例.其中孤立性下腔静脉离断5例,均足月分娩,除3例合并内脏反位外,新生儿超声心动图检查及生长发育均未见异常.复杂性下腔静脉离断7例,均因合并先天性心脏畸形引产,引产后经尸体解剖证实6例为左侧异构畸形,1例为右侧异构畸形.结论胎儿下腔静脉离断的超声表现典型,产前容易发现.如伴有先天性心脏畸形,通常提示合并异构畸形,尤其是左侧异构畸形.
목적 분석태인하강정맥리단적산전초성특점급기여이구기형적관계,지재제고태인이구기형적산전진단솔. 방법 대2010년1월지2013년12월재북경대학인민의원산전검사혹인가의태인기형전입본원회진적잉부,진행상규태인초성심동도검사,병상규소사태인복강횡절면.대복강횡절면표현위기정맥증관、하강정맥소실적태인,이용시간-공간관련성상기술진일보명학시부유하강정맥리단,근거시부합병유심장결구이상분위복잡성하강정맥리단화고립성하강정맥리단,대계속임신자수방지생후,신생인행초성심동도검사,대종지임신자인산태인행시체해부. 결과 산전공진단하강정맥리단12례.기중고립성하강정맥리단5례,균족월분면,제3례합병내장반위외,신생인초성심동도검사급생장발육균미견이상.복잡성하강정맥리단7례,균인합병선천성심장기형인산,인산후경시체해부증실6례위좌측이구기형,1례위우측이구기형.결론 태인하강정맥리단적초성표현전형,산전용역발현.여반유선천성심장기형,통상제시합병이구기형,우기시좌측이구기형.
Objective To analyze the ultrasonic features of interrupted inferior vena cava (IVC) and its relationship with related deformities so as to improve the prenatal diagnosis of isomerism.Methods Pregnant women who received prenatal care in Peking University People's Hospital or who were referred to our hospital for suspected malformation of fetus between January 2010 and December 2013 were enrolled in this study.Fetal echocardiography and abdominal transverse section were performed routinely.Spatio-temporal image correlation technology was used to further clarify interrupted IVC if azygos vein was broadened or IVC disappeared in the fetal abdominal transverse sections.Based on the presence of cardiac structural abnormalities,interrupted IVC was divided into isolated IVC interruption and complex IVC interruption.Neonatal echocardiography was performed in women with continued pregnancies.In women with terminated pregnancy,fetus was autopsied after induced labor.Results In total,12 cases of interrupted IVC were diagnosed,including 5 cases of isolated IVC interruption with full-term delivery and 7 cases of complex IVC interruption.Neonatal echocardiography,abdominal ultrasound were all normal in the 5 cases of isolated IVC interruption except for 3 cases complicated with sistus inversus viscerum.All the 7 cases of complex IVC interruption had induced labor because of some congenital cardiac abnormalities.Autopsy showed that 6 cases had left isomerism,and 1 case had right isomerism.Conclusions Interrupted IVC can be easily identified in prenatal diagnosis due to the typical ultrasonic features.Complication with some congenital cardiac abnormalities often indicates isomerism,especially left isomerism.