超声心动图诊断胎儿完全性大动脉转位

摘要

目的 探讨胎儿完全性大动脉转位(TGA)的超声心动图特征.方法 回顾性分析2010年1月-2017年1月经引产后尸体解剖证实或经出生后超声心动图检查证实为TGA的9胎胎儿的产前超声资料.结果 9胎TGA胎儿四腔心切面均显示正常的心轴及房室连接关系;左心室流出道切面8胎出现“雏鸟喙”征;左右心室流出道切面8胎2条大动脉(主动脉、肺动脉)呈平行关系;三血管气管(3VT)切面6胎仅显示2条大血管;主动脉弓切面7胎显示主动脉弓弧度不同程度增大.四腔心切面及左心室流出道切面均可见4胎室间隔上段缺损.结论 TGA胎儿超声心动图左心室流出道切面、左右心室流出道切面、3VT切面及主动脉弓切面均具有特征性表现,包括“雏鸟喙”征、2条大动脉呈平行关系、3VT切面仅显示2条大血管、主动脉弓弧度增大,其中以“雏鸟喙”征最为常见.%Objective To investigate the echocardiographic features of complete transposition of the great arteries (TGA)in fetuses.Methods Prenatal echocardiographic data of 9 fetuses diagnosed as TGA by autopsy or postnatal echocardiography during January 2010 to January 2017 were retrospectively analyzed.Results All of 9 fetuses showed normal cardiac axis and atrioventricular connection on four-chamber view.Eight of them showed the "baby bird's beak" sign on left ventricular outflow tract view.On left and right ventricular outflow tracts view,the two great arteries were parallel in 8 fetuses.Totally 6 fetuses showed just 2 vessels on three vessels and tracheal (3VT) view.On aortic arch view,the radian of aortic arch had increased in different degrees in 7 fetuses.There were 4 fetuses with ventricular septal defect observed by both of four-chamber and left ventricular outflow tract views.Conclusion The echocardiographic features of fetuses with TGA are characteristic in left ventricular outflow tract,left and right ventricular outflow tracts,3VT and aortic arch views,including "baby bird's beak" sign,2 great arteries' parallel relations,only 2 vessels on 3VT view,and increased radian of aortic arch.Of these features,"baby bird's beak" sign is the most common.