胎儿心脏的正常和异常超声解剖.pdf

胎儿心脏的正常和异常超声解剖 刘子建 香港中文大学妇产科学系 Prenatal diagnosis of CHD 先天性心脏病的产前诊断 • Retrospective review • 131,60 routine scan of low risk pregnancies • Sensitivity: 9.25 only. Stoll C et al Prenat Diagn 1993 4 Chamber View 四腔心 4 chamber view: Sensitivity 四腔心：敏感性 • 1022 high risk pregnancies: 92% Copel JA et al. AJOG 1987 • 3680 low risk pregnancies: 81% Vergani P et al. AJOG 1992 • 5400 low risk pregnancies: 48% Achiron R et al BMJ 1992 • 15,281 low risk pregnancies: 16% Crane JP et al. AJOG 1994 29,035 fetuses 1991-2001 35/82 major CHDs detected 43% on routine scan 58 CHDs expected to have 71% Abn 4-chamber views 41/58 detected by 71% Abn 4-chamber views Tegnander Eik-Nes UOG 2006 Experience and pick-up rate 经验和发现率 • 58 CDHs with expected abn 4- chamber views • 87.5% detected by experienced ones • 50% detected by less experienced Experienced: 2,000 scans ones Less Experienced: 200 scans Tegnander Eik-Nes UOG 2006 Common CHD 常见的先天性心脏病 • Dextroposition and dextrocardia