摘要: |
目的 总结分析胎儿双主动脉弓的超声心动图特征,探讨产前超声心动图诊断胎儿双主动脉弓的应用价值。方法 回顾性分析我院经产前超声心动图诊断为双主动脉弓胎儿的超声心动图及临床资料,分析超声心动图特征,随访产后诊断结果,总结产前超声心动图诊断经验。
结果 共计17例胎儿产前超声心动图诊断为双主动脉弓,其中右弓优势型11例,对称型6例;合并室间隔缺损1例,合并双上腔静脉并冠状静脉增宽2例,无合并其他心内畸形14例;出生6例,终止妊娠2例,9例失访;出生后出现症状2例,无症状4例;接受手术治疗1例。与胎龄相匹配的正常胎儿比较,病例组胎儿的左右心房内径、左右心室内径、卵圆孔大小、升主动脉与肺动脉内径及峰值流速差异均无统计学意义(p>0.05)。双主动脉弓胎儿典型的超声心动图特征表现为:(1)在三血管-气管(3VT)切面显示两条主动脉,将气管与食管包绕,并与动脉导管形成“9”字形血管环;(2)在3VT切面均显示左位动脉导管;(3)升主动脉冠状切面可见升主动脉发出两条主动脉弓,降主动脉冠状切面可见两条主动脉弓汇入降主动脉;(4)主动脉弓长轴切面可见左、右主动脉弓各发出两个分支;(5)3VT向头侧连续扫查显示两条主动脉弓及分支走行。结论 双主动脉弓胎儿具有独特的产前超声心动图特征,三血管-气管切面对诊断胎儿双主动脉弓具有重要意义,发现左、右两个主动脉弓及分支走行是诊断的关键。 |
关键词: 产前诊断 胎儿超声心动图 双主动脉弓 血管环 |
DOI: |
投稿时间:2018-06-26修订日期:2018-12-25 |
基金项目:重庆市社会事业与民生保障科技创新专项重点研发项目(cstc2017shms-zdyfX0017);第三军医大学临床研究项目(2015YLC10) |
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Prenatal echocardiographic features of fetal double aortic arch |
Tangqi,Xiahongmei |
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Abstract: |
Abstract:Objective Analyzed The echocardiographic features of fetal biaortic arch,to explore the value of prenatal echocardiography in diagnosis of fetal double aortic arch (DAA).Methods Echocardiography and clinical data of fetuses diagnosed with double aortic arch by prenatal echocardiography in our hospital were retrospectively analyzed, echocardiography characteristics were analyzed, postpartum diagnosis results were followed up, and prenatal echocardiography diagnosis experience was summarized. Result There were 17 cases with DAA (the right arch was dominant in 11cases,two arches were balanced in 6 cases);3 cases were complicated with other cardic anomalies, 14 cases with isolated DAA. Termination of pregnancy was selected in 2 cases,9 cases were missing and 6 cases were borned;2 cases were symptomatic and 4 were asymptomatic; and 1 case underwent surgery. Compared with the control group, there was no statistically significant difference in fetal basic test values in the case group (p > 0.05). Typical echocardiographic features of fetal biaortic arch are as follows:(1)The characteristic "9" vascular ring can be seen in the fetus of DAA on the 3-vessel-trachea (3VT) view;(2)The arterial duct is left on 3-VT view;(3) In the coronary section of ascending aorta, the ascending aorta sends out two aortic arches. In the coronary section of descending aorta, two aortic arches converge into descending aorta.(4)Each aortic has two branches;(5)Continuous scan can see the left and right arch and branches. Conclusions DAA fetuses have unique characteristics of prenatal echocardiography. 3-VT view plays an important role in the diagnosis of fetal double aortic arch, it is found that the left and right aortic arches and branches are the key to diagnosis. |
Key words: Prenatal diagnosis Fetal Echocardiography Double aortic arch Vasular ring |