Rikitake N, Takechi T, Suzuki K, Matsunaga S, Yoshioka F, Kato H
J Cardiogr. 1981 Dec;11(4):1319-27.
Two-dimensional echocardiography has developed to the routine examination to diagnose congenital heart disease. In this study, we studied the value of two-dimensional echocardiography for evaluating the development of the fetal heart and for prenatal diagnosis of congenital heart disease. We studied 100 fetuses whose gestational ages were 16-40 weeks of pregnancy. The examination was performed with Toshiba Sonolayer-V model SSL-53M. The scanners were the 2.25 MHz linear and sector transducers. The images were recorded on videotapes. Changing the scanner direction according to the fetal position, we recorded the left ventricular long-axis view, short-axis view of great arteries and four-chamber view. In the four-chamber view, diameters of the tricuspid and mitral valve rings were measured. In the short-axis view of great arteries, the diameters of the aorta and pulmonary artery were measured. We identified the right and left ventricles by detecting both the great arteries and attaching sites of the atrioventricular valves. The identification of the aorta was made by detecting the arch and the identification of the pulmonary artery was made by depicting its two branches. Cardiac structures were identified on the fetus over five months of pregnancy. In many instances recordings were obtained in 7 months fetuses. The success rate to get clear recordings was 88% of all cases in the four-chamber view, 75% in the short-axis view of great arteries and 71% in the left ventricular long-axis view, respectively. The average ratio of the mitral to tricuspid valvular diameter and that of the pulmonary arterial to aortic diameter were both less than 1, suggesting the right ventricular dominance in fetal hearts. From these findings, it might be possible to diagnose prenatally certain congenital heart diseases such as atrioventricular valve atresia and semilunar valve atresia which require the critical evaluation and management in the neonatal periods.
二维超声心动图已发展成为诊断先天性心脏病的常规检查方法。在本研究中，我们探讨了二维超声心动图在评估胎儿心脏发育及先天性心脏病产前诊断中的价值。我们研究了100例孕周为16 - 40周的胎儿。检查使用东芝Sonolayer - V型SSL - 53M超声诊断仪。探头为2.25MHz线阵和扇扫探头。图像记录于录像带上。根据胎儿体位改变探头方向，记录左心室长轴切面、大动脉短轴切面及四腔心切面。在四腔心切面测量三尖瓣和二尖瓣环直径。在大动脉短轴切面测量主动脉和肺动脉直径。通过观察大动脉及房室瓣附着部位来识别左右心室。通过观察主动脉弓来识别主动脉，通过描绘肺动脉的两个分支来识别肺动脉。妊娠5个月以上胎儿的心脏结构可被识别。多数情况下可获得7个月胎儿的图像记录。四腔心切面、大动脉短轴切面及左心室长轴切面图像清晰记录成功率分别为88%、75%和71%。二尖瓣与三尖瓣直径比值及肺动脉与主动脉直径比值均小于1，提示胎儿期右心室优势。基于这些发现，有可能对某些先天性心脏病进行产前诊断，如房室瓣闭锁和半月瓣闭锁，这些疾病在新生儿期需要进行严格评估和处理。
