心脏检查方法.doc

A Primer for Fetal Cardiac Imaging A Stepwise Approach for 2-Dimensional Imaging 胎儿心脏超声检查入门：循序渐进的二维图像诊断American Institute of Ultrasound in Medicine (AIUM) and the International Society of Ultrasound in Obstetrics and Gynecology outlined recent guidelines for sonographic evaluation of the fetal heart. The International Society of Ultrasound in Obstetrics and Gynecology guidelines include the “basic”cardiac examination that relies on a 4-chamber view.There are key features of this sonographic view that will be emphasized in this article. This society also included the “extended basic” examination that includes the right and left ventricular out-flow tracts (RVOTand LVOT, respectively). It is important to include imaging that demonstrates the relationship of the LVOT and the RVOT to detect conotruncal abnormalities.美国超声医学协会（AIUM）和国际妇产科超声协会最近针对胎儿心脏超声检查出台了一项指南。国际妇产科超声协会指南包括了基于四腔心切面的最基本的心脏检查，其中重点强调了在此超声切面上的几个关键征象，同时指南还包括了“进一步”的检查，包括对左右心室流出道（RVOT和LVOT）的检查，明确两者的关系对于发现圆锥动脉干畸形非常重要。Depending on technical factors, such as maternal body habitus, fetal age, or fetal position, demonstrating the relationship of the RVOT and the LVOT may be problematic. Alternatives to routine 2-dimensional (2-D) imaging of out-flow tracts include the use of 3-D imaging technologies including the use of dynamic multiplanar imaging. Even with advanced imaging and the ability to reconstruct images in different planes, the examiner must be familiar with routine cardiac views or failure of detection of CHD may still occur. Thus, understanding basic cardiac views is necessary to detecting CHD even with more advanced imaging. We will concentrate on a method to best understand these basic views, such as the 4-chamber or outflow tract views, as a springboard to more advanced cardiac imaging. An alternative to these views is a comprehensive examination of the fetal heart, which may be obtained using 4 to 5 short-axis views of the heart. These 5 planes include (1) the stomach; (2) the 4-chamber view of th