胎儿永存左上腔静脉畸形解剖铸型诊断价值分析：5例病例及文献回顾

doi:10.13418/j.issn.1001-165x.2025.5.20

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中国临床解剖学杂志 ›› 2025, Vol. 43 ›› Issue (5) : 622-625. DOI: 10.13418/j.issn.1001-165x.2025.5.20

畸形与变异

胎儿永存左上腔静脉畸形解剖铸型诊断价值分析：5例病例及文献回顾

黄瑞铃^1,2 ，王瑜^1,3，艾海东³，欧红萍^1,3，胡阳³，吕洋⁴，贾咏梅^1,3*

作者信息 +

Analysis of the diagnostic value of anatomical casting in fetal persistent left superior vena cava malformation: a case series of five and literature review

Huang Ruiling^1,2, Wang Yu^1,3, Ai Haidong³, Ou Hongping^1,3, Hu Yang³, Lv Yang ⁴, Jia Yongmei^1,3 *

Author information +

文章历史 +

摘要

本文报道5例经解剖铸型确诊的胎儿永存左上腔静脉（PLSVC）畸形病例，通过改良牙托粉-硫酸钡混合灌注技术构建三维心血管铸型模型，结合超声影像进行解剖学验证。病例孕周22~30周，其中3例为左无名静脉缺如型PLSVC，2例为左无名静脉桥接型，合并右室双出口（4例）、肺动脉狭窄（3例）及右位主动脉弓（2例）等复杂畸形。铸型技术清晰呈现了PLSVC血管走行及其与心内畸形的空间关系，尤其揭示桥接型PLSVC形成的“Y”型血流通道特征，此类变异易被常规超声误判。研究表明，解剖铸型可立体还原复杂心血管结构，为产前超声提供精准解剖参照，有助于提升产前诊断准确性与临床决策质量。

Abstract

This article reports on five cases of fetal persistent left superior vena cava (PLSVC) diagnosed through anatomical casting techniques. By utilizing an improved dental plaster-barium sulfate infusion method, three-dimensional cardiovascular casting models were created and validated against ultrasound imaging. The cases were between 22 to 30 weeks of gestation. Among them, three presented with the absence of the left brachiocephalic vein type of PLSVC, while two exhibited the bridging type, complicated by various anomalies such as double outlet right ventricle (four cases), pulmonary artery stenosis (three cases), and right aortic arch (two cases). The casting technique clearly illustrated the course of the PLSVC and its spatial relationships with intracardiac malformations, particularly revealing the “Y” shaped blood flow pathway characteristic of the bridging type PLSVC, which is often misinterpreted in routine ultrasound examinations. This research indicates that anatomical casting can accurately reconstruct complex cardiovascular structures, providing precise anatomical references for prenatal ultrasound, thereby enhancing the accuracy of prenatal diagnosis, and improving clinical decision-making quality.

导出引用

黄瑞铃, 王瑜, 艾海东, 欧红萍, 胡阳, 吕洋, 贾咏梅. 胎儿永存左上腔静脉畸形解剖铸型诊断价值分析：5例病例及文献回顾[J]. 中国临床解剖学杂志. 2025, 43(5): 622-625 https://doi.org/10.13418/j.issn.1001-165x.2025.5.20

Huang Ruiling, Wang Yu, Ai Haidong, Ou Hongping, Hu Yang, Lv Yang, Jia Yongmei. Analysis of the diagnostic value of anatomical casting in fetal persistent left superior vena cava malformation: a case series of five and literature review[J]. Chinese Journal of Clinical Anatomy. 2025, 43(5): 622-625 https://doi.org/10.13418/j.issn.1001-165x.2025.5.20

中图分类号： R322.35

参考文献

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基金

湖北省科技厅面上项目指导性项目（2022CFC042）；湖南省自然科学基金医卫行业联合基金（2025JJ81001）；中华国际医学交流基金会医药临床与成果转化基金-妇产领域疾病科研专项基金科研项目（Z-2014-08-2309-30）；湖北省科技厅临床研究中心，湖北省胎儿复杂畸形精准诊断临床研究中心（2021LC002）；襄阳市科技局医疗卫生领域科技计划重点项目（2021YL19）；广东省医学科学基金项目（No.A2023057; No.A2022007）；襄阳市重点研发计划项目（2022YL44A）