摘要
目的:总结胎儿期发现的下腔静脉(IVC)回流异常且不伴其他心脏结构畸形(孤立性IVC回流异常)的产前超声图像特点,探讨胎儿超声心动图诊断切面,提高诊断准确性。方法:2010年1月至2015年12月,产前共检出孤立性IVC回流异常15例,孕周23~34周,平均(27.9±3.3)周。总结孤立性IVC异常回流的类型及胎儿超声心动图诊断技巧。结果:11 724例胎儿中,共检出15例孤立性IVC异常回流,发生率约0.12%。其中IVC肝段缺如(IVC离断)11例,左位IVC 3例,双IVC 1例。1例IVC离断伴奇静脉扩张引产尸检证实诊断,余出生后超声心动图证实诊断。IVC离断时,血流通过扩张的奇静脉回流入上腔静脉,观察切面为上腹部横切面、四腔心切面、三血管切面、上腔静脉长轴及降主动脉-奇静脉长轴切面。左位IVC及双IVC时,下腹部横切面及降主动脉-IVC长轴切面为主要诊断切面,其他切面未见异常表现。结论:孤立性IVC回流异常并不引起血流动力学改变,预后良好。但是发生率低,诊断困难。
Objective: To describe the echocardiographic features of abnormal inferior vena cava( IVC)return without other heart defects( isolated anomalous IVC return) and to evaluate the diagnostic value of fetal echocardiography. Methods: Fifteen isolated anomalous IVC return fetuses were prenatally diagnosed from Jan2010 to Dec 2015. Gestational age was 23-34 weeks,mean( 27. 9 ± 3. 3) weeks. The types of abnormality and the echocardiographic features were discussed. Results: In 11724 fetuses,15 isolated IVC were diagnosed including 11 interrupted IVC,3 left IVC and 1 double IVC. The incidence was 0. 12%. Autopsy was performed in 1 interrupted IVC,and others were followed-up by neonatal echocardiography. In interrupted IVC,the blood flow returns to superior vena cava through dilated azygos vein or hemiazygos vein,the diagnosis views were upper abdominal transverse section,apical four chamber view,three-vessel view,vena cava long axis view and descending aorta-azygos vein long axis view. While for left IVC and double IVC,the diagnosis views were the lower abdominal transverse section and descending aorta-inferior vena cava long axis view,and no abnormal findings on other views. Conclusion: Isolated IVC is very rare and the diagnosis is difficult,the accurate diagnosis is relied on multiple echocardiographic views. The outcome is favorable since there is no hemodynamic changes for isolated IVC return.
出处
《心肺血管病杂志》
2016年第8期628-631,共4页
Journal of Cardiovascular and Pulmonary Diseases
基金
科技部"十二.五"支撑计划(2014BAI08B07)
胎儿心脏病母胎医学研究北京市重点实验室(B20308)
关键词
孤立性下腔静脉回流异常
下腔静脉离断
左位下腔静脉
双下腔静脉
胎儿超声心动图
Isolated anomalous inferior vena cava return
Interrupted inferior vena cava
Left inferior vena cava
Double inferior vena cava
Fetal Echocardiography