新生儿时期特殊类型动脉导管未闭的超声表现及预后

The sonographic features and prognosis of special types of patent ductus arteriosus in neonates

目的探讨新生儿期特殊类型动脉导管未闭的超声表现,以及预后情况。方法 2015年1月~2016年7月在我院出生的新生儿,因听诊闻及心脏杂音进行超声心动图检查,在出生后的48h内进行超声心动图检查,发现5例特殊类型的动脉导管未闭。回顾性分析胎儿期超声检查,均未提示动脉导管形态及连接存在异常。结果 5例新生儿的超声影像学主要表现为:肺动脉主干与降主动脉之间可见瘤样管腔相连通,一端连于肺动脉主干后外侧,一端连于降主动脉。肺动脉主干开口端可测及舒张期为主的连续性负向血流频谱,舒张期血流峰速约(2.16±0.41)m/s;降主动脉开口端可测及较低速的血流,血流峰速约(0.56±0.27)m/s。6~12个月后复查,肺动脉主干与降主动脉之间连通管腔消失,主动脉-肺动脉分流消失。结论该类型的动脉导管未闭可能是主动脉和肺动脉的连接异位,但可以自行闭合。

Objective To analyze the ultrasonographic features and prognosis of the neonates with special type of patent ductus arteriosus （PDA）. Methods From January 2015 to July 2016, newborns in our hospital had cardiac murmur, then were taken echocadiography within 48 hours after birth, and special types of PDA was detected in 5 newborns. A retrospective analysis of fetal ultrasonography was conducted, the five patients showed no abnormal shape and pipe connection. Results The imaging findings of 5 neonates were mainly manifested as： between the main pulmonary artery and the descending aorta, the dilated lumen was connected, one end was connected to the posterolateral part of the pulmonary artery, with one end connected to the descending aorta. The continuous negative blood flow spectrum could be measured in the lumen opens at the pulmonary artery, the diastolic peak velocity was （2.16±0.41） m/s; In the lumen connected to the descending aorta, the peak velocity was （0.56±0.27） m/s. 6~12 months later check again, the aortic-pulmonary shunt disappeared. Conclusion The special types of PDA may be the abnormal connection position of aortic-pulmonary, and can be self closed.