Gembruch U, Chatterjee M S, Bald R, Redel D A, Hansmann M
Department of Prenatal Diagnosis and Therapy, University Hospital, Bonn, Fed. Rep. Germany.
J Perinat Med. 1991;19(1-2):27-32. doi: 10.1515/jpme.1991.19.1-2.27.
Color Doppler flow mapping of fetal heart was performed in 582 fetuses between 16 and 38 weeks of gestation. Congenital heart diseases were excluded in 522 fetuses correctly. In 59 fetuses structural and/or functional cardiac abnormalities were diagnosed. In one fetus small multiple ventricular septal defects were missed. The most important additional information obtained by color Doppler flow mapping was: (1) Diagnosis of insufficiencies of atrioventricular valves; (2) Demonstration of turbulent high velocity jet in stenosis of semilunar valve; (3) Reverse flow in ascending aorta in atresia of aortic valves and on ductus arteriosus and main pulmonary artery in atresia of pulmonary valves; (4) Reverse perfusion of ductus arteriosus and main pulmonary artery as well as an antegrade turbulent high velocity jet in severe pulmonary stenosis as part of tetralogy of Fallot; (5) Bidirectional interventricular shunting of blood in ventricular septal defect. Color Doppler flow mapping allows rapid screening for flow abnormalities of the fetal heart. Exact localisation of sample volume by pulsed wave Doppler in area of abnormal flow pattern is possible, thus significantly reducing the Doppler examination time. The accuracy of prenatal diagnosis of congenital heart diseases is improved by application of color Doppler flow mapping, in particular in presence of complex cardiac defects.
对582例孕16至38周的胎儿进行了胎儿心脏彩色多普勒血流成像检查。522例胎儿被正确排除先天性心脏病。59例胎儿被诊断出存在心脏结构和/或功能异常。1例胎儿漏诊了多发性小室间隔缺损。彩色多普勒血流成像获得的最重要的额外信息有：（1）房室瓣关闭不全的诊断；（2）半月瓣狭窄时高速湍流喷射的显示；（3）主动脉瓣闭锁时升主动脉内的反流以及肺动脉瓣闭锁时动脉导管和主肺动脉内的反流；（4）法洛四联症中严重肺动脉狭窄时动脉导管和主肺动脉的逆向灌注以及正向高速湍流喷射；（5）室间隔缺损时血液的双向心室分流。彩色多普勒血流成像可快速筛查胎儿心脏的血流异常。通过脉冲波多普勒在异常血流模式区域精确放置取样容积是可行的，从而显著缩短多普勒检查时间。彩色多普勒血流成像的应用提高了先天性心脏病产前诊断的准确性，尤其是在存在复杂心脏缺陷的情况下。
