Viñals F, Tapia J, Giuliano A
Ultrasound Department, Clinica Sanatorio Alemán, Concepción, Chile.
Ultrasound Obstet Gynecol. 2002 Mar;19(3):246-9. doi: 10.1046/j.1469-0705.2002.00651.x.
To improve the detection of ductal dependence in fetuses with severe anomalies of the outflow tracts by observing, with directional power Doppler, reverse flow through the aortic arch or ductus arteriosus in a transverse view of the upper mediastinum.
A slight cranial move of the ultrasound beam from the three-vessel view allows the transverse view of the aortic arch and ductus arteriosus to be visualized simultaneously. This view is orthogonal to the fetal body axis and parallel to the plane of the four-chamber view. In normal fetuses, directional power Doppler interrogation at this level identifies forward flow in both oblique vessels.
We examined 43 fetuses with cardiac defects. In five of the cases, there was reversed flow in the aortic arch or ductus arteriosus in addition to severe anomalies of the outflow tracts, including four with hypoplastic left ventricle and one with pulmonary atresia.
Prenatal detection of reversed flow in the aortic arch or ductus arteriosus is associated with complex congenital heart disease with major diminution of forward flow to the corresponding great vessels.
通过在上纵隔横切面使用方向性功率多普勒观察主动脉弓或动脉导管内的反向血流，提高对伴有严重流出道异常胎儿的导管依赖性的检测。
将超声束从三血管视图向头侧轻微移动，可同时显示主动脉弓和动脉导管的横切面。该视图与胎儿身体轴线正交，与四腔心视图平面平行。在正常胎儿中，在此水平进行方向性功率多普勒检查可识别两条斜行血管内的正向血流。
我们检查了43例有心脏缺陷的胎儿。其中5例除有严重的流出道异常外，主动脉弓或动脉导管内还存在反向血流，包括4例左心室发育不全和1例肺动脉闭锁。
产前检测到主动脉弓或动脉导管内的反向血流与复杂先天性心脏病相关，相应大血管的正向血流显著减少。
