胎儿超声心动图结合大血管铸型对胎儿心脏畸形的漏误诊分析

发布时间：2018-04-08 20:58

本文选题：大血管铸型　切入点：胎儿超声心动图　出处：《中国超声医学杂志》2017年04期

【摘要】：目的对比研究胎儿心脏超声与大血管铸型,分析产前诊断胎儿心脏畸形的漏误诊原因,以提高产前诊断准确率。方法选取安贞胎儿心脏病数据库及标本库21例心脏畸形胎儿的产前影像数据及大血管铸型数据进行对比。结果大血管铸型显示,21例胎儿引产后均被证实存在复杂心脏畸形,主要诊断吻合率可达100%(21/21)。共存在46处心脏畸形,其中产前超声心动图误诊2处(4.35%,2/46,证实为动脉导管缺如1例、肝静脉回流异常1例);漏诊心脏畸形9处(19.57%,9/46,证实为动脉导管走行异常3例、动脉导管形态异常2例、上腔静脉回流异常2例、锁骨下动脉迷走2例)。结论胎儿超声心动图对血管走行异常最容易漏诊,通过铸型在产前对此类畸形提高认识有助于提高产前诊断的准确率。
[Abstract]:Objective to study the causes of misdiagnosis in prenatal diagnosis of fetal cardiac malformation by contrasting fetal heart ultrasound and macrovascular casting, and to improve the accuracy of prenatal diagnosis.Methods Anzhen fetal heart disease database and specimen bank were used to compare the antepartum image data and macrovascular cast data of 21 fetuses with cardiac malformation.Results all 21 cases of fetal induced labor were proved to have complicated cardiac malformation. The main diagnostic anastomosis rate was 100% 21 / 21%.There were 46 cardiac malformations, of which 2 misdiagnosed by prenatal echocardiography were 4.35 / 46, which were confirmed as missing ductus arteriosus in 1 case, abnormal hepatic venous reflux in 1 case, 9 misdiagnosed cardiac malformations in 9 cases (19.57 / 46), and confirmed 3 cases of anomalous arterial ducts.The arterial ducts were abnormal in 2 cases, the superior vena cava in 2 cases and the subclavian artery misguided in 2 cases.Conclusion Fetal echocardiography is the most easily missed diagnosis of abnormal blood vessels, and it is helpful to improve the accuracy of prenatal diagnosis by means of mould casting to improve the recognition of this kind of malformation.
【作者单位】：首都医科大学附属安贞医院母胎医学会诊中心首都医科大学附属安贞医院超声心动二部;福建医科大学附属福建省妇幼保健院;江苏省淮安市妇幼保健院;江西省萍乡市妇幼保健院;河北省遵化市人民医院;
【基金】：胎儿心脏病母胎医学研究北京市重点实验室(No.BZ0308) 心血管疾病精准医学北京实验室(No.116211) 胎儿心脏病产前预后评价体系及出生救治路径建立(No.XMLX201604)
【分类号】：R540.45;R714.5

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