Abstract:Objective: To explore the application value of coronal plane in ultrasonic diagnosis of fetal total anomalous pulmonary venous drainage(TAPVD). Methods: A series of coronal sections of the chest and abdomen were obtained with the beam coming from the left or right side of the fetuses in 19 cases of simple total anomalous pulmonary venous drainage (TAPVD) diagnosed by echocardiography to demonstrate location and path of pulmonary venous drainage. The types of the total anomalous pulmonary venous drainage were classified and compared with postpartum echocardiography results, surgical results or autopsy results. Results: All 19 cases of simple fetal TAPVD were confirmed postpartum, including 8 cases of supracardiac type. There were 8 cases with complete drainage pathway displayed and accurately classificated using coronal plane imaging. There were 6 cases of intracardiac type, and there were 2 cases with complete drainage location and pathway displayed and accurately classificated by coronal plane. There were 2 cases of infracardiac type, and there were 2 cases with complete drainage pathway displayed and accurately classificated by coronal plane. There were 3 cases of mixed type, of which 2 cases’ drainage pathway was supercardiac type+subcardiac type, and 1 was supercardiac type+intracardiac type, and there were 2 cases with complete drainage pathway displayed and accurately classificated by coronal plane. Conclusion: For the fetal supracardiac type and infracardiac type TAPVD, coronal section has obvious advantages, which can judge the pulmonary venous drainage path quickly and accurately, make accurate classification and provide accurate guidance for clinical prognosis evaluation. For the display of pulmonary venous drainage pathway in intracardiac type TAPVD, the advantage of coronal section is not obvious. For the mixed type TAPVD, coronal plane shows the drainage path with a certain advantage because of its complex and varied drainage path. Coronal section has guiding value for the diagnosis of obstruction and the location of obstruction in the pulmonary venous drainage pathway.
王 锟,张晓花,董凤群. 冠状切面在胎儿完全型肺静脉异位引流超声诊断中的应用价值[J]. 中国临床医学影像杂志, 2019, 30(1): 21-23.
WANG Kun, ZHANG Xiao-hua, DONG Feng-qun. Application value of coronal plane in ultrasonic diagnosis of fetal total anomalous pulmonary venous drainage. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(1): 21-23.
[1]邓学东. 产前超声诊断与鉴别诊断[M]. 北京:人民军医出版社,2013:122-124.
[2]王新房. 超声心动图学[M]. 第4版. 北京:人民卫生出版社,2009:593-600.
[3]朱晓东,张宝仁. 心脏外科学[M]. 北京:人民卫生出版社,2007:381-382.
[4]李治安. 胎儿超声心动图实用指南:正常和异常心脏[M]. 第2版. 天津:天津科技翻译出版公司,2011:279-287.
[5]Seale AN, Carvalho JS, Gardiner HM, et al. Total anomalouspulmonary venous connection: impact of prenatal diagnosis[J]. Ultrasound Obstet Gynecol, 2012, 40(3): 310-318.
[6]Dong FQ, Zhang YH, Li ZA, et al. Evaluation of normal fetal pulmonary veins from the early second trimester by enhanced-flow(e-flow) echocardiography[J]. J Intern Soc Ultrasound Obstet Gynecol, 2011, 38(6): 652-657.
[7]耿斌,张玉珍. 临床儿童及胎儿超声心动图学[M]. 天津:天津出版传媒集团,2015:203-204.
[8]Mavroudis C, Backer CL, 刘锦纷,孙彦隽译. 小儿心脏外科学[M]. 第4版. 上海:上海世界图书出版公司,2014:743-744.
[9]刘琳译. 胎儿超声心动图实用指南:正常和异常心脏[M]. 第3版. 北京:北京科学技术出版社,2017:500-511.
[10]Yun TJ, Coles JG, Konstantinov IE, et al. Conventional and sutureless techniques for management of the pulmonary veins: evolution of indications from postrepair pulmonary vein stenosis to primary pulmonary vein anomalies[J]. J Thorac Cardiovasc Surg, 2005, 129(1): 167-174.
[11]Restrepo MS, Cerqua A, Turek JW. Pentalogy of Cantrell with Ectopia Cordis Totalis, Total Anomalous Pulmonary Venous Connection, and Tetralogy of Fallot: A Case Report and Review of the Literature[J]. Congenit Heart Dis, 2014, 9(4): E129-E134.
[12]徐红亮,范顺阳,王峰峰,等. 影响完全性肺静脉异位引流术病死率的危险因素[J]. 中华实用儿科学杂志,2013,28(6):474-476.