【摘要】 目的探讨产前超声诊断胎儿三尖瓣下移畸形的临床价值。方法回顾性分析6例经胎儿超声心动图诊断为三尖瓣下移畸形的超声诊断资料与随诊结果,总结其异常声像图特点。结果6例胎儿均经尸体解剖证实为三尖瓣下移畸形,其中三尖瓣隔叶下移2例,隔叶及后叶下移3例,隔叶、后叶及前叶下移1例。6例三尖瓣下移畸形中4例伴有功能右室缩小,合并房间隔缺损1例,肺动脉狭窄1例;4例伴有胸、腹腔及心包积液。胎儿三尖瓣下移畸形主要声像图表现为右心扩大,三尖瓣叶附着点下移,心尖到二尖瓣前叶附着点的距离与到三尖瓣隔叶附着点的距离比值≥1.8,形成典型房化右室特征;彩色血流显示三尖瓣重度反流,其反流起源点低,反流面积大,但反流速度低,平均反流速度217.0 cm/s。结论胎儿三尖瓣下移畸形具有特征性声像图表现,产前超声诊断胎儿三尖瓣下移畸形具有重要临床价值。更多还原

【Abstract】 Objective To explore the clinical value of ultrosonic diagnosis of fetal Ebstein’s anomaly in prenatal.Methods The data of echocardiography and follow-up results of 6 fetal Ebstein’s anomaly were retrospective analyzed,and their abnormal ultrasound imaging characteristic were summarized.Results Six cases were proved into Ebstein’s anomaly by autopsy,including septal tricuspid leaflet displacement(2 cases),septal and posterior tricuspid leaflets displacement(3cases),septal and posterior and anterior tricuspid leaflets displacement(1 case).There were 4 cases combined with right ventricle dysplasia,1 case with atrial septal defect,1 case with pulmonary stenosis,and 4 cases with hydrothorax,ascibes and pericardial fluid.The echocardiography of fetal Ebstein’s anomaly was characterized by right atrial enlargement,displacement of tricuspid valve attachment point,the distance ratio of between cardiac apex and bicuspid valve attachment point and between cardiac apex and tricuspid valve attachment point exceeding(1.8),forming typical atrialized right ventricle feature,color blood flow indicating severe tricuspid regurgitation with low initial point,large area and slow speed(mean speed:(217.0)(cm/s).)Conclusions The fetal Ebstein’s anomaly has characteristic sonogram.Ultrasonic diagnosis of fetal Ebstein’s anomaly has great clinical value in prenatal.更多还原