先天性血管环8例产前超声诊断

Prenatal sonographic diagnosis of congenital vascular rings in eight fetuses

目的 探讨先天性血管环的产前超声影像特点. 方法 回顾性分析2010年1月9日至2012年11月25日潍坊医学院附属医院诊断的8例先天性血管环胎儿的超声声像特点.采用三血管气管切面观察主动脉弓的位置、分支及动脉导管的位置与走行,总结血管环的声像图特点.结果 8例血管环形成病例的孕母年龄21～35岁,平均（28±5）岁;检查时孕周为22～28周,平均（25±2）周.7例通过胎儿出生后本院或外院心脏超声确诊,1例引产病例通过尸检确诊.8例胎儿中,胎儿中右位主动脉弓并迷走左锁骨下动脉、左位动脉导管7例,双主动脉弓1例.7例右位主动脉弓并迷走左锁骨下动脉、左动脉导管病例超声表现为环绕气管周围的“U”形血管环,此“U”形结构由右位主动脉弓、迷走左锁骨下动脉、左位动脉导管环绕气管形成, “U”形血管环的另一侧为心底结构,为完全血管环.1例双主动脉弓病例表现为左右两侧动脉弓形成“O”形血管环包绕气管. 结论 三血管气管切面显示环绕气管周围“U”形或“O”形血管环是先天性血管环的典型超声表现.对怀疑血管环的病例应重点进行心脏超声检查.

Objective To explore the prenatal sonographic diagnosis of congenital vascular rings. Methods Eight fetuses with congenital vascular rings diagnosed in Affiliated Hospital of Weifang Medical College from January 9, 2010 to November 25, 2012 were retrospectively analyzed. All cases underwent three- vessel trachea view to observe the position of aortic arch, its branches and the ductus arteriosus. The sonographic features were summarized. Results The eight cases were diagnosed at 22 to 28 gestional weeks, with an average of （ 25±2 ） weeks. They were 21 to 35 years old, with an average of （ 28±5 ） years. Seven cases were diagnosed by cardiac ultrasonography, and one induction case was diagnosed by autopsy. Among the eight cases, there were seven of right aortic arch with vagus left subclavian artery and left ductus arteriosus, and one case was complicated with double aortic arch. The former seven cases showed U-shape vascular ring surrounding the trachea composed of right aortic arch, vagus left subclavian artery and left ductus arteriosus. The other side of this U-shape was the heart structure, showing a complete vascular ring. In the latter one case, the O-shape vascular ring was composed of left and right sides of the aortic arch. Conclusion The U shape, or O-shape vascular ring in three-vessel trachea view is the typical sonographic features of congenital vascular ring. Cardiac ultrasound examination should be performed on those suspected cases.