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目的探讨妊娠晚期胎儿动脉导管形态变化的超声诊断价值,分析胎儿导管形态变化的临床意义。方法选择2013年5月至2015年3月用多普勒超声诊断仪检查的256例(共314次)孕周为26~40周的胎儿为观察对象,根据孕周进行分组,孕周为26~31+6周的为Ⅰ组(136次),孕周为32~36+6周的为Ⅱ组(108次),孕周在37周以上的为Ⅲ组(70次),分析胎儿动脉导管形态变化与孕周的关系,观察合并动脉导管瘤的情况。结果Ⅰ组胎儿动脉导管形态超声检查显示为直线型、轻度弯曲型、显著弯曲型(C或S型)的分别为38、70、28次,分别占27.94%、51.47%、20.59%;Ⅱ组胎儿动脉导管形态超声检查显示为直线型、轻度弯曲型、显著弯曲型(C或S型)的分别为14、60、34次,分别占12.96%、55.56%、31.48%;Ⅲ组胎儿动脉导管形态超声检查显示为直线型、轻度弯曲型、显著弯曲型(C或S型)的分别为4、30、36次,分别占5.71%、42.86%、51.43%;胎儿动脉导管为直线型的,随着孕周的增加,所占百分比逐渐降低,显著弯曲C型或迂回S型,随着孕周的增加,所占百分比逐渐升高;有2例显著弯曲型(C或S型)的合并动脉导管瘤,1例C型者合并有动脉导管瘤的同时也合并卵圆孔狭窄并房间隔瘤形成。结论超声检查能清晰显示胎儿动脉导管的形态,具有较高的临床应用价值;随着胎龄的增加,胎儿动脉导管逐渐弯曲,因而胎儿动脉导管弯曲不应该诊断为胎儿动脉导管形态异常。
Objective To investigate the value of ultrasonic diagnosis of fetal ductal changes in late pregnancy and to analyze the clinical significance of fetal ductal changes. Methods A total of 256 (314) fetuses with gestational weeks of 26 to 40 weeks examined by Doppler sonography were selected from May 2013 to March 2015. The gestational age was 26 The patients in group Ⅰ (136 times) ~ 31 + 6 weeks, group Ⅱ (108 times) in gestational weeks 32 ~ 36 + 6 weeks and patients in group Ⅲ (70 times) The relationship between the change of catheter shape and gestational age, and the observation of the status of arterioles. Results The ultrasound examination of fetal ductus arteriosus in group Ⅰ showed linear and mild flexion type with significant curvatures (C or S type) of 38, 70 and 28 times, accounting for 27.94%, 51.47% and 20.59%, respectively The group of fetal arterial catheter ultrasonography showed linear, mild flexion type, and significant flexion type (C or S type) were 14,60,34 times, accounting for 12.96%, 55.56%, 31.48% respectively; Group Ⅲ fetus The diameter of the ductus arteriosus was 4, 30 and 36 times, accounting for 5.71%, 42.86% and 51.43%, respectively. The diameter of the ductus arteriosus was linear Type, with the gestational age increased, the percentage decreased gradually, significantly curved C-type or circuitous S-type, with the gestational age increased, the percentage increased gradually; there are 2 cases of significant curved type (C or S type ) Of the merger of the arterioles, 1 case of type C with arteriolar tumor also combined with foramen ovale and atrial septal tumor formation. Conclusion Ultrasonography can clearly show the morphology of fetal ductus arteriosus, which has a high clinical value. With the increase of gestational age, the ductus arteriosus curves gradually. Therefore, the curve of the ductus arteriosus should not be diagnosed as the abnormal shape of the ductus arteriosus.