[1]赖远芳 翁宗杰 凌 文 吴秋梅 邱秀青 党婷婷 马 宏刘 敏.产前超声与解剖铸型在胎儿肺动脉发育异常诊断中的应用价值[J].福建医药杂志,2020,42(06):1-5.
　LAI Yuanfang,WENG Zongjie,LING Wen,et al.Role of antenatal ultrasound and vascular cast, autopsy in the diagnosis of pulmonary artery dysplasia[J].FUJIAN MEDICAL JOURNAL,2020,42(06):1-5.
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产前超声与解剖铸型在胎儿肺动脉发育异常诊断中的应用价值()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期数:
2020年06期
页码:
1-5
栏目:
临床研究
出版日期:
2020-12-15

文章信息/Info

Title:
Role of antenatal ultrasound and vascular cast, autopsy in the diagnosis of pulmonary artery dysplasia
文章编号:
1002-2600(2020)06-0001-05
作者:
赖远芳 翁宗杰 凌 文 吴秋梅 邱秀青1 党婷婷 马 宏2刘 敏3
福建省妇幼保健院超声科(福州 350001)
Author(s):
LAI Yuanfang;  WENG Zongjie;  LING Wen;  WU Qiumei;  QIU Xiuqing;  DANG Tingting;  MA Hong;  LIU Min.
Department of Ultrasonography, Fujian Maternity and Child Health Hospital, Fuzhou,Fujian 350001,China
关键词:
胎儿;  肺动脉发育异常;  产前超声;  血管铸型
Keywords:
fetus;  pulmonary artery dysplasia;  prenatal ultrasound;  vascular cast
分类号:
R726.1
文献标志码:
B
摘要:
目的 探讨产前超声与解剖铸型在胎儿肺动脉发育异常诊断中的应用价值。方法 回顾性分析35例胎儿肺动脉发育异常的产前超声图像,与解剖铸型标本对照,分析其特征及鉴别要点。结果 胎儿肺动脉发育异常中,肺动脉及其分支大小异常30例(肺动脉狭窄18例,肺动脉闭锁9例,肺动脉瓣缺如综合征3例),肺动脉起源异常5例(一侧肺动脉缺如2例,肺动脉起自升主动脉2例,肺动脉吊带1例)。引产后病理解剖25例,血管铸型10例。超声误诊3例:肺动脉闭锁误诊为共同动脉干1例,肺动脉闭锁误诊为肺动脉狭窄1例,室间隔缺损型肺动脉闭锁肺血来源误诊1例。结论 胎儿肺动脉发育异常中肺动脉闭锁和狭窄较为常见,产前超声对胎儿肺动脉发育异常具有重要诊断价值,解剖及铸型的反馈有助于进一步认识胎儿肺动脉发育异常。
Abstract:
Objective To investigate the value of antenatal ultrasound and vascular cast, autopsy in diagnosis of pulmonary artery dysplasia(hereinafter referred to as PAD).Methods Thirty-five fetuses with prenatal-ultrasound-diagnosed PAD were enrolled in this study.Ultrasound images were retrospectively processed for analysis, comparing with autopsy and vascular cast.Results Among the 35 fetuses with PAD, 30 of them were found dysplasia of pulmonary artery and its branches in pipe diameter(18 in stenosis, 9 in atresia, 3 in dilation), anomalous origin of pulmonary artery in 5 cases(absence of unilateral pulmonary artery in 2 cases, origin of pulmonary artery from ascending aorta in 2 cases, pulmonary artery sling in 1 case).Twenty-five cases underwent autopsy and 10 cases for vascular cast after termination.Three anomalies were misdiagnosed or missed diagnosed by ultrasound, one pulmonary atresia misdiagnosed as common arterial trunk, another one pulmonary atresia misdiagnosed as pulmonary stenosis, one blood supply of lung of pulmonary atresia with ventricular septal defect misdiagnosed.Conclusion Among the cases of PAD, pulmonary stenosis and atresia are most common.Antenatal ultrasound has significant diagnostic value in these cases.Feedback from autopsy and vascular cast is helpful for further understanding of PAD.

参考文献/References:

[1] 董凤群,赵真.先天性心脏病实用超声诊断学[M].第2版.北京:人民军医出版社,2011.
[2] 接连利,刘清华,许燕,等.超声在产前诊断胎儿肺动脉闭锁中的应用价值[J].中华超声影像学杂志,2005,14(11):844-846.
[3] 翁宗杰,刘敏,吴秋梅,等.胎儿右侧异构综合征产前超声与病理解剖及血管铸型的对照研究[J].中华超声影像学杂志,2017,26(10):845-849.
[4] Gardiner H,Belmar C,Tulzer G,et al.Morphologic and functional predictors of eventual circulation in the fetus with pulmonary atresia or critical pulmonary stenosis with intact septum[J].J Am Coll Cardiol,2008,51(13):1299-130.
[5] 刘友兰,肖萤,胡雪飞.胎儿肺动脉狭窄的超声特征[J].医学临床研究,2014,31(2):383-384.
[6] Lowenthal A,Lemley B,Kipps A K,et al.Prenatal tricuspid valve size as a predictor of postnatal outcome in patients with severe pulmonary stenosis or pulmonary atresia with intact ventricular septum[J].Fetal Diagn Ther,2014,35(2):101-107.
[7] Taddei F, Signorelli M, Groli C, et al.Prenatal diagnosis of ventriculocoronary arterial communication associated with pulmonary atresia[J].Ultrasound Obstet Gynecol,2003(21):413-415.
[8] Gómez O, Soveral I, Bennasar M, et al.Accuracy of fetal echocardiography in the differential diagnosis between truncus arteriosus and pulmonary atresia with ventricular septal defect[J].Fetal diagnosis and therapy, 2016,39(2): 90-99.
[9] 张志芳,张玉奇,陈树宝,等.肺动脉闭锁伴室间隔缺损的产前超声诊断价值分析[J].医学影像学杂志,2015, 25(6):989-992,997.
[10] Peterson R E,Levi D S,Williams R J,et al.Echocardiographic predictors of outcome in fetuses with pul monary atresia with intact ventricular septum[J].J Am Soc Echocardiogr,2006,19(11):1393-1400.
[11] Tenisch E, Raboisson M J, Rypens F, et al.Significance of lung anomalies in fetuses affected by tetralogy of Fallot with absent pulmonary valve syndrome[J].Cardiol Young, 2017, 27(9): 1740-1747.
[12] Kruzliak P, Syamasundar R P, Novak M, et al.Unilateral absence of pulmonary artery: pathophysiology, symp toms, diagnosis and current treatment[J].Arch Cardiovasc Dis,2013, 106(8/9):448-454.

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备注/Memo

备注/Memo:
基金项目:福建省自然科学基金资助项目(2017J01235)1 妇产科; 2 病理科; 3 通信作者
更新日期/Last Update: 1900-01-01