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。
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.
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