三维和四维超声产前诊断胎儿心脏畸形的临床进展

摘要

The diagnosis of complex prenatal congenital heart diseases is difficult. Two-dimensional echocardiogram is the gold standard for prenatal imaging of fetal heart. In recent years, three- and four-dimensional echocardiogram has been developing rapidly for the diagnosis of fetal congenital heart diseases.The acquisition of three-dimensional volume data is based on the application of two-dimensional imaging techniques, including grey scale, color Doppler, power doppler, and B flow modalities. A wide array of post-processing tools, such as surface mode, inversion mode, and tomographic ultrasound imaging, can display the features of fetal heart. Motion display modes include cine-loop and spatiotemporal image correlation.Several developments of three- and four-dimensional imaging techniques facilitate the application in clinical settings. The application of three-and four-dimensional technology appears to be helpful for the understanding of cardiac anatomy, vascular development, and cardiac function. Three-and four-dimensional echocardiogram in the diagnosis of fetal congenital heart diseases opens an entirely new array of diagnostic modalities in clinical practice.%复杂先天性心脏畸形在产前期诊断困难,二维超声心动图是胎儿心脏畸形产前诊断的基本检查方法.近年来,三维、四维超声在胎儿心脏产前筛查的应用发展迅速.三维超声心脏容积信息联合应用二维超声影像技术,通过表面成像、反转成像、断层显像等一系列后处理技术,开辟了先天性心脏畸形产前检查的全新视角.三维胎儿心脏超声的迅速发展促进了临床诊断的应用.通过电影回放和时间-空间相关成像等动态显示模式,三维、四维胎儿超声心动图可实时动态显示胎儿心脏三维容积信息,更直观显示心房、心室和大动脉的解剖结构和空间关系,并能评估胎儿心脏容积,测算射血分数和每搏量.