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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.美國超聲醫(yī)學協(xié)會（AIUM）和國際婦產(chǎn)科超聲協(xié)會最近針對胎兒心臟超聲檢查出臺了一項指南。國際婦產(chǎn)科超聲協(xié)會指南包括了基于四腔心切面的最基本的心臟檢查，其中重點強調(diào)了在此超聲切面上的幾個關鍵征象，同時指南還包括了“進一步”的檢查，包括對左右心室流出道（RVOT和LVOT）的檢查，明確兩者的關系對于發(fā)現(xiàn)圓錐動脈干畸形非常重要。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，有時顯示ROVT和LOVT的關系比較的困難。除了可以通過常規(guī)二維圖像來顯示流出道外，還可以應用三維影像技術包括使用多維動態(tài)圖像技術來顯示流出道。即便是具備了
