1 市立豊中病院小児科Department of Pediatrics, Toyonaka Municipal Hospital ◇ Osaka, Japan
2 大阪府立母子保健総合医療センター小児循環器科Department of Pediatric Cardiology, Osaka Medical Center for Maternal and Child Health ◇ Osaka, Japan
近年，出生前診断が広がりを見せるなかで，胎児心臓診断が本邦においても急速に増加している現状である．画像技術の進歩も相まって，従来は胎児診断が困難とされていた先天性心疾患が診断されるようになり，また胎児期から先天性心疾患の心機能を評価することや出生後の状態・予後を予測することも可能となってきた．それら胎児心臓診断における新しい指標として，①心機能評価に対するもの：組織ドップラー法（tissue Doppler imaging: TDI），Tei index（myocardial performance index: MPI），cardiovascular profile score（CVPS） ②心形態診断：‘I-shaped’sign, Post LA space index（PLAS index），U-sign ③生後状態の評価・予後判定：左心低形成症候群における肺静脈血流パターンと母体酸素負荷テストでのpulsatility index（PI），完全大血管転位における卵円孔と動脈管，をピックアップしてそれぞれについての解説を行う．
In Japan, there has recently been a marked increase in fetal heart diagnosis concomitant with an overall increase in the diagnosis of prenatal diseases. With advances in imaging technology, congenital heart disease, which previously was difficult to diagnose in the fetus, can now be successfully diagnosed prenatally. Furthermore, it is now possible to evaluate cardiac function and predict prognosis after birth. In this article, I identify new indicators in fetal echocardiography and provide comprehensive yet concise commentaries as follows: (i) cardiac function assessment by tissue Doppler imaging (TDI), myocardial performance (Tei) index, and cardiovascular profile score (CVPS); (ii) anatomical diagnosis by I-shaped sign, post LA space index (PLAS index), and U-sign; and (iii) prediction of the status and prognosis after birth by assessment of pulmonary venous flow pattern and pulsatility index (PI) during maternal hyperoxygenation testing in hypoplastic left heart syndrome, foramen ovale, and the ductus arteriosus in transposition of great arteries.
Key words: prenatal diagnosis; congenital heart disease; fetal echocardiography; new indicator
© 2016 特定非営利活動法人日本小児循環器学会© 2016 Japanese Society of Pediatric Cardiology and Cardiac Surgery
This page was created on 2016-08-24T16:14:35.591+09:00
This page was last modified on 2016-09-28T20:06:02.34+09:00
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