Prenatal ultrasonic diagnosis of fetal isolated levocardia / 中华超声影像学杂志

Objective To investigate the clinical application valve of prenatal ultrasound in diagnosis of fetal isolated levocardia ( IL ) . Methods Thirty-eight IL fetuses diagnosed in three prenatal diagnosis centers from 2000 to 2016 were reviewed with their prenatal ultrasound features and cardiac and extracardiac malformations . Results Thirty-eight IL cases included 19 cases of left isomerism ( LI) ,14 cases of right isomerism( RI) and 5 non-classified cases . The overall incidence of malformations in IL patients was 97 .4％with 94 .7％ in LI patients and 100％ in RI patients . The incidence of cardiac malformations was 92 .1％with 84 .2％ in LI patients and 100％ in RI patients . The most common congenital heart diseases were:right ventricle outlet obstruction , univentricular physiology and atrioventricular septal defect . Anomalous pulmonary venous connection was more commonly seen in LI patients than in RI patients . The most common extracardiac malformation was duodenal obstruction( 86 .9％ ) . Inferior vena cava interruption and polysplenia were more commonly seen in LI patients .Juxtaposition of aorta and inferior vena cava and asplenia were more commonly seen in RI patients . Conclusions IL is very rarely seen in population with high incidence of congenital heart diseases and extracardiac malformations .

Prenatal ultrasonic diagnosis and outcome of fetal inferior vena cava malformation / 中华超声影像学杂志

Objective To evaluate the clinical value of prenatal ultrasound in the diagnosis of inferior vena cava malformation.Methods The ultrasonographic features of 95 cases of fetal inferior vena cava malformation were retrospectively analyzed,and compared with autopsy or postpartum follow-up.Results Among the 95 cases of fetal inferior vena cava malformation,39 cases were confirmed by autopsy,56 cases were diagnosed by neonatal ultrasonography,5 cases were confirmed by angiography or operation.Among them,37 cases were interrupted inferior vena cava,37 cases were double inferior vena cava,21 cases were left inferior vena cava.Forty of the 95 cases were terminate pregnancy(due to intracardiac or extracardiac malformations)or neonatal deaths(42.1%),and 55 cases had good prognoses(57.9%).Conclusions Prenatal ultrasound has important clinical value in diagnosing of inferior vena cava malformation,clearing whether it is associated with other malformations and assessing fetal prognosis.

Evaluation of right ventricular systolic function by tricuspid annular displacement / 中国医师杂志

Objective To explore the value of tricuspid annular displacement (TAD) in evaluating right ventricular systolic function by speckle tracking imaging.Methods Forty healthy people (RVEF ＞50%) and forty five patients(RVEF ＜50%)were enrolled in this study.The apical four-chamber view was obtained and tricuspid annular midpoint displacement (TADmid) were measured by speckle tracking imaging.Right ventricular ejection fraction (RVEF) was measured by three-dimensional echocardiography.The correlation of tricuspid annular midpoint displacement (TADmid) and right ventricular ejection fraction (RVEF) was analyzed.Results These was statistical significance of tricuspid annular midpoint displacement between healthy people (RVEF ＞ 50%) and patients (RVEF ＜ 50%) (t = 7.28,P ＜ 0.01).There was positive correlation between TADmid and RVEF (P ＜ 0.01).The correlation coefficient between TADmid and RVEF was 0.76 (P ＜ 0.0l).The cut-off value of TADmid for RVEF ＞ 50% was 9.7 with a sensitivity of 72% and a specificity of 86%.Conclusions TAD by speckle tracking imaging showed an excellent correlation with RVEF.Tricuspid annular displacement by speckle tracking imaging was a simple and easy method,and it might be a new index in assessing right ventricular systolic function in clinical practice.