胎儿孤立完全性血管环常见类型产前超声诊断研究

Prenatal ultrasound diagnosis of fetal isolated complete vascular ring

目的通过胎儿超声心动图观察孤立完全性血管环(CVR)的特征,测量气管横截面积(TA)和血管环面积(VRA),以期为围产期管理提供依据。方法选取2010年8月至2015年11月首都医科大学附属北京安贞医院超声心动图二部胎儿心脏病母胎医学会诊中心胎儿数据库资料中诊断孤立完全性血管环胎儿92例作为病例组,并选取同期正常胎儿92例作为对照组,于三血管气管观观察超声特征并测量主动脉弓水平气管横截面积(TA)和血管环面积(VRA)。结果病例组92例孤立完全性血管环胎儿气管横截面积测值(2.39±1.26)mm2小于对照组正常胎儿(5.27±1.49)mm2测值,病例组92例孤立完全性血管环胎儿血管环面积测值为(48.92±19.10)mm2,右位主动脉弓伴左位动脉导管胎儿77例,表现为"U"字形血管环,双主动脉弓胎儿15例,表现为"O"字形或"λ"形血管环。结论胎儿超声心动图能诊断孤立完全性血管环,孤立完全性血管环对胎儿气管有一定程度受压,气管横截面积测值小于对照组正常胎儿。

Objective To observe characters in isolated complete vascular ring（CVR）fetuses and to evaluate the trachea area（TA） and vascular ring area（VRA） changes by fetal echocardiography.Methods Ninety-two fetuses with isolated complete vascular ring were diagnosed by fetal echocardiography prenatally and confirmed by postnatal echocardiography,from August 2010 to November 2015 in the Department of Ultrasound in Beijing Anzhen Hospital and Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories.The VRA and TA were measured at the three vessel-trachea view,and the parameters were compared.Results The TA was decreased in vascular ring fetuses compared with normal fetuses [（5.27±1.49） mm2 vs（2.39±1.26） mm2].The VRA of vascular ring fetuses was（48.92±19.10） mm2.Right aortic arch and left ductus arteriosus formed ＂U＂ shaped in 77 cases.Double aortic arch formed ＂O＂ shaped or ＂λ＂ shaped in 15 cases.Conclusions Fetal echocardiography can accurately diagnosed isolated complete vascular ring.The TA decreased in vascular ring fetuses compared with normal fetuses.