彩色多普勒超声检测心脏结构异常胎儿肺静脉血流流速曲线的价值

摘要

目的 观察分析彩色多普勒超声在心脏结构异常胎儿检测中的应用及肺静脉血流流速曲线的变化.方法 回顾性分析在我院体检的1500例孕妇资料,将诊断为心内结构畸形的21例胎儿分为异常组,随机抽取正常胎儿21例为正常组.对比分析两组胎儿的肺静脉超声频谱S峰、D峰、A峰及S/D、S/A、(S-A)/D值.统计不同心内结构异常的(S-A)/D值,分析其与胎儿心内结构异常的关系.结果 两组肺静脉S峰、D峰之间比较差异无统计学意义(P＞0.05),组间S/D、S/A值比较差异无统计学意义(P＞0.05).异常组A峰明显偏低,且(S-A)/D值明显高于正常组,差异有统计学意义(P＜0.05).左心室肥厚胎儿(S-A)/D值相对较低,左心发育不良胎儿(S-A)/D值相对最高,不同心内结构畸形胎儿的(S-A)/D值有明显差异(P＜0.05).彩色多普勒超声在左心发育不良漏诊1例,单纯室间隔缺损漏诊1例,漏诊率0.13％.结论 彩色多普勒超声可较准确地诊断胎儿心脏结构异常,其(S-A)/D值存在明显差异,可将肺静脉血流流速作为观察的重要指标.%Objective To observe the changes of color Doppler ultrasonography in fetal detection of abnormal cardiac structure and changes of pulmonary venous flow velocity curve.Methods 1500 pregnant women in our hospital were analyzed.The diagnosis of intracardiac malformation was divided into abnormal group (21 cases),while 21 normal fetuses were randomly selected as normal group.The S peak,D peak,A peak and S/D,S/A,(S-A)/D of the pulmonary vein ultrasonography were compared between the two groups.(S-A)/D values were analyzed for different intracardiac structures,and their relationship with fetal cardiac structure was analyzed.Results There was no significant difference in S-ray and D-peak between the normal heart and the children with abnormal cardiac structure (P＞ 0.05) and there was no significant difference in S/D and S/A between the two groups (P＞ 0.05).(S-A)/D value was significantly higher than that of normal structure fetus (P＜0.05).Left ventricular hypertrophy (S-A)/D value was relatively low.The left ventricular dysplasia fetal (S-A)/D value was relatively highest.The different intracardiac malformations of fetal (S-A)/D value was significantly different (P＜0.05).Color Doppler ultrasonography missed 1 case of left ventricular dysplasia,simple ventricular septal defect missed 1 case.The missed diagnosis rate of 0.13％.Conclusion Color Doppler ultrasound can be more accurate diagnosis of fetal heart structure abnormalities.The pulmonary venous flow can be used as an important indicator of observation.