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目的:评价超声产前诊断胎儿左心发育不良综合征(HLHS)的准确性。方法:回顾性分析8例产前诊断为胎儿左心发育不良综合征的病例资料,对其超声特点进行分析,评估超声心动图诊断产前胎儿左心发育不良的准确性。结果:8例HLHS胎儿经引产后7例经尸检证实,产后超声证实1例。心尖四腔心切面:8例中均显示左、右心比例失常、左心室狭小;三血管切面:8例主动脉内径明显小于肺动脉,主、肺动脉内径比例失常,血流方向相反;主动脉弓切面:8例主动脉弓内反向血流;肺静脉频谱:8例肺静脉收缩时出现返流。结论:产前超声心动图对胎儿HLHS能够做出准确诊断,对围产期的监测和临床决策有重要指导意义。
Objective: To evaluate the accuracy of ultrasound in the diagnosis of fetal left heart hypoplasia syndrome (HLHS). Methods: Eight cases of prenatal diagnosis of fetal hypoplastic left heart syndrome were retrospectively analyzed. Their ultrasonic features were analyzed to evaluate the accuracy of echocardiography in the diagnosis of prenatal fetal left heart dysplasia. Results: Eight cases of HLHS fetus were confirmed by autopsy after induced labor and 1 case was confirmed by postpartum ultrasound. In the apex four-chamber view, the left and right ventricles were abnormal in all 8 cases and the left ventricle was narrow. The three-vessel section showed that the diameter of the aorta was significantly smaller than that of the pulmonary artery in 8 cases, and the ratio of the main and pulmonary artery was reversed. 8 cases of aortic arch reverse blood flow; pulmonary venous spectrum: 8 cases of pulmonary venous shunt reflux. Conclusion: Prenatal echocardiography can make accurate diagnosis of fetus HLHS, which has important guiding significance for perinatal monitoring and clinical decision-making.