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1、胎儿的循环系统英文版FetalCardiologyRiskFactorsforcongenitalheartdisease:FamilyhistoryRecurrencerisk(hypoplasticleftheartashighas13.5%)NongestationalDMMaternalinfection(rubella)LupusDrugs(anticonvulsants,etoh,amphetamines,ocp,vitA,steroids,etc.)FetalCardiologyAIUM/ACRs
2、tandardsinthe2ndand3rdtrimestersinclude:FourchamberviewPositionoffetalheartinthethoraxLVOTandRVOTnotyetpartofstandards4chamberviewalone:33-63%sensitiveWithoutflowtracts:83-85%sensitive[2]GOALSReviewnormalcardiacanatomyanditssonographicappearance(fourchamber,
3、LVOT,RVOT)ExplorediagnosticpitfallsReviewtheappearanceofmorecommonstructuralcardiacdefectsTheFourChamberViewHeartfillsonethirdofthechestTheFourChamberViewApexpointstotheleft(45degreeangle)TheFourChamberViewSizeofrightchambersapproximatesleftchambersTheFourCh
4、amberViewMVandTVmoveonrealtimeimagingVentricularseptumsymmetricTheFourChamberViewPortionoftheatrialseptumpresent(crus)LeftVentricularOutflowTractIdentify:LV,RV,IVseptum,aorta(normalcaliber),+/-LA,+/-RAMedialwalloftheascendingaortamergeswiththetopoftheIVseptu
5、m(mostfrequentlocationforVSD)Pathology:VSD,tetralogyofFallot,transposition,truncusarteriosusRightVentricularOutflowTractIdentify:branchingofthemainPAintorightPAandductusarteriosus(todescAorta),ascaortaincrosssection,descaortatoleftofspine;verifyPAcrossesante
6、riortoascaortaPathology:transposition,truncusarteriosusSpineSpLeftAtriumRightAtriumLeftVentricleRightVentricleModeratorBandForamenOvaleFourChamberInterventricularSeptumLeftAtriumLeftVentricleRightVentricleAortaMitralValve(closed)AorticValve(open)Interventric
7、ularSeptumLeftVentricularOutflowTractRightVentricularOutflowTractRightAtriumRightVentricleMainPulmonaryArteryRightPulmonaryArteryDuctusArteriosusAscendingAortaAoTricuspidValvePulmonicValve(open)DescendingAortadAoSpPitfalls:PseudoVSDWhentheIVseptumparallelsth
8、eUSbeam,resultantechodropoutlookslikeVSDIVseptumnormallytapersneartheAVvalvesCorrectedbychangingtheangleofviewIVseptumparallelsUSbeam(echodropout)ChangingAnglePericardialeffusion???NO!!!Normalam