Analysis of missed diagnosis of fetal mitral valve diseases by prenatal ultrasound
10.3760/cma.j.issn.1004-4477.2019.12.005
- VernacularTitle: 超声心动图检测胎儿二尖瓣病变漏诊分析
- Author:
Xin WANG
1
;
Xiaowei LIU
1
;
Jiancheng HAN
1
;
Ye ZHANG
1
;
Xiaoyan GU
1
;
Jianfeng SHANG
2
;
Yihua HE
1
Author Information
1. Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories in Beijing of Beijing Anzhen Hospital, Capital Medical University, Beijing Lab for Cardiovascular Precision Medicine, Beijing 100029, China
2. Department of Pathology, Beijing Anzhen Hospital, Beijing 100029, China
- Publication Type:Clinical Trail
- Keywords:
Ultrasonography, prenatal;
Mitral valve;
Fetus
- From:
Chinese Journal of Ultrasonography
2019;28(12):1035-1039
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the pathology and ultrasonic characteristics of fetal mitral valve diseases and improve their prenatal diagnostic accuracy by ultrasound.
Methods:Ultrasonic data of fetuses with mitral valve diseases, diagnosed by autopsy from January 2011 to December 2017 in Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories were retrospectively analyzed. Their ultrasound features and causes of missed diagnosis were analyzed.
Results:①The pathologic types included mitral atresia(22 cases, 59.5%), mitral valve dysplasia(13 cases, 35.1%) and mucoid degeneration[2 cases (1 case was diagnosed with Marfan syndrome with dilated aortic sinus and sinus of pulmonary trunk), 5.4%]. ②Fetal ultrasound could detect mitral atresia and mucoid degeneration of mitral valve. There were five cases of mitral valve dysplasia which were missed by ultrasound.And the accuracy rate of ultrasonic diagnosis was 86.5%(32/37). ③The missed subtypes of mitral valve dysplasia included mild-moderate mitral stenosis with coarctation of aorta (4 cases) and mitral valve dysplasia with functional aortic atresia(1 case).
Conclusions:Fetal mitral valve diseases involve a variety of anatomical abnormalities and the main types are mitral atresia and mitral valve dysplasia. Mucoid degeneration of mitral valve is rare and it may belong to Marfan syndrome when combined with dilated aortic sinus and sinus of pulmonary trunk. Fetal ultrasound can identify mitral atresia and mucoid degeneration of mitral valve, but it may miss the diagnosis of some subtypes of mitral valve dysplasia, such as mild-moderate mitral stenosis with aortic coarctation and mitral valve dysplasia with functional aortic atresia.
