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上腔静脉异常的产前超声心动图诊断

Prenatal echocardiographic diagnosis of superior vena cava abnormalities

  • 摘要: 目的 通过分析总结胎儿上腔静脉异常的超声特征,提高产前超声心动图诊断的准确度。方法 回顾性分析产前诊断的11例上腔静脉异常胎儿超声心动图图像,总结其超声特征。结果 11例胎儿中永存左上腔(或称双侧上腔静脉)9例;孤立性左上腔2例。胎儿期超声特征如下:①主要切面:三血管气管切面。永存左上腔时,此切面呈“四血管征”;孤立性左上腔时,此切面显示上腔静脉位于肺动脉左侧,右侧上腔静脉缺如。②辅助切面:四腔心切面,左房左缘可见上腔静脉横断面;四腔心下切面,扩张的冠状静脉窦可显示;胸颈部左矢状旁切面,上腔静脉汇入扩张的冠状静脉。结论 上腔静脉异常胎儿期有典型的超声图像,综合上述切面图像特征是准确诊断的关键。

     

    Abstract: Objective To improve the accuracy of prenatal echocardiography diagnosis by analyzing and summarizing the ultrasonic features of fetal superior vena cava abnormalities.Methods The echocardiographic features of 11 fetuses with abnormal superior vena cava were analyzed retrospectively.Results There were 9 cases of persistent left superior vena cava (or bilateral superior vena cava) in 11 fetuses. Isolated left superior vena cava were in 2 cases. The fetal echocardiography characters as following:Main section:Three-vessel trachea section. When the upper left cavity was persistent, this section presents "four-vessel sign". In the isolated upper left cavity, this section showed the superior vena cava on the left side of the pulmonary artery, and the right superior vena cava was absent. Auxiliary section:① In the four-cavity central incised surface, the transverse section of superior vena cava could be seen at the left margin of left atrium. ② In the low section of the four-cavity heart, dilated coronary sinus could be displayed. ③ In the left sagittal side view of thoracic and cervical part, the superior vena cava merged into the dilated coronary vein.Conclusions There are typical ultrasound images of abnormal superior vena cava in fetal period. The key to accurate diagnosis is to synthesize the features of the above-mentioned cross-sectional images.

     

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