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1、APrimerforFetalCardiacImagingAStepwiseApproachfor2-DimensionalImaging(UltrasoundQuarterly2008;24:195Y206)AmericanInstituteofUltrasoundinMedicine(AIUM)andtheInternationalSocietyofUltrasoundinObstetricsandGynecologyoutlinedrecentguidelinesforsonographicevaluationofthefetalheart.TheInternationalSocie
2、tyofUltrasoundinObstetricsandGynecologyguidelinesincludethe“basic”cardiacexaminationthatreliesona4-chamberview.Therearekeyfeaturesofthissonographicviewthatwillbeemphasizedinthisarticle.Thissocietyalsoincludedthe“extendedbasic”examinationthatincludestherightandleftventricularout-flowtracts(RVOTandL
3、VOT,respectively).ItisimportanttoincludeimagingthatdemonstratestherelationshipoftheLVOTandtheRVOTtodetectconotruncalabnormalities.美國(guó)超聲醫(yī)學(xué)協(xié)會(huì)（AIUM）和國(guó)際婦產(chǎn)科超聲協(xié)會(huì)最近針對(duì)胎兒心臟超聲檢查出臺(tái)了一項(xiàng)指南。國(guó)際婦產(chǎn)科超聲協(xié)會(huì)指南包括了基于四腔心切面的最基本的心臟檢查，其中重點(diǎn)強(qiáng)調(diào)了在此超聲切面上的幾個(gè)關(guān)鍵征象，同時(shí)指南還包括了“進(jìn)一步”的檢查，包括對(duì)左右心室流出道（RVOT和LVOT）的檢查，明確兩者的關(guān)系對(duì)于發(fā)現(xiàn)圓錐動(dòng)脈干畸形非常重要。Depend
4、ingontechnicalfactors,suchasmaternalbodyhabitus,fetalage,orfetalposition,demonstratingtherelationshipoftheRVOTandtheLVOTmaybeproblematic.Alternativestoroutine2-dimensional(2-D)imagingofout-flowtractsincludetheuseof3-Dimagingtechnologiesincludingtheuseofdynamicmultiplanarimaging.Evenwithadvancedima
5、gingandtheabilitytoreconstructimagesindifferentplanes,theexaminermustbefamiliarwithroutinecardiacviewsorfailureofdetectionofCHDmaystilloccur.Thus,understandingbasiccardiacviewsisnecessarytodetectingCHDevenwithmoreadvancedimaging.Wewillconcentrateonamethodtobestunderstandthesebasicviews,suchasthe4-
6、chamberoroutflowtractviews,asaspringboardtomoreadvancedcardiacimaging.Analternativetotheseviewsisacomprehensiveexaminationofthefetalheart,whichmaybeobtainedusing4to5short-axisviewsoftheheart.These5planesinclude(1)thestomach;(2)the4-chamberviewoftheheart;(3)the5-chamberviewoftheheart;(4)thepulmonar
7、yartery(PA)bifurcation;and(5)thealignmentofthe3vessels,whicharethePA,aorta,andsuperiorvenacava(SVC).由于一些技術(shù)上的原因，比如母體的體質(zhì)、胎齡或者胎兒體位等因素的影響，有時(shí)顯示ROVT和LOVT的關(guān)系比較的困難。除了可以通過(guò)常規(guī)二維圖像來(lái)顯示流出道外，還可以應(yīng)用三維影像技術(shù)包括使用多維動(dòng)態(tài)圖像技術(shù)來(lái)顯示流出道。即便是具備了
