胎儿双主动脉弓的产前超声诊断探讨

Prenatal echocardiography in the diagnosis of fetal double aortic arch

目的探讨胎儿产前超声诊断双主动脉弓的诊断思路。方法回顾性分析2013-2018年湖南省6个超声产前诊断中心检查数据库胎儿双主动脉弓的超声图像特点、伴发畸形及与解剖或产后随访结果对照。结果双主动脉弓超声心动图主要特点为三血管-气管切面显示升主动脉有分叉,发出右主动脉弓和左主动脉弓,包绕气管与食管形成完全性血管环。29例双主动脉畸形中,8例(28%)合并其他心内外畸形,1例存在22q11染色体缺失。5例通过尸体解剖证实,24例通过产后CTA证实(8例通过手术进一步证实)。结论系统的产前超声检查可以诊断胎儿双主动脉弓畸形,明确是否伴有其他畸形,对于评估胎儿预后具有重要的临床价值。

Objective To explore the way of prenatal echocardiography in the diagnosis of fetal double aortic arch.Methods The data of fetuses diagnosed as double aortic arch in 6 prenatal centers in Hunan in echocardiograms performed at 20-36 weeks of gestation from 2013 to 2018 were reviewed.The characteristics of echocardiographic with double aortic arch,and the associated malformations were observed,the clinical outcome were analyzed.Results The main echocardiographic features of the double aortic arch were three-vessel-tracheal views,which showed a bifurcation of the ascending aorta and a ring consisted of aortic right and left arch.From this retrospective analysis,29 double aortic arches were identified,which 8 cases(28%)combined with cardiac defect and extracardiac abnormalities,1 case with 22q11 deletion.Among them,5 cases were confirmed by autopsy,24 cases were diagnosed by computed tomography angiography(8 cases were confirmed by operation).Conclusions Systematic prenatal echocardiography in the diagnosis of fetal double aortic arch has significant clinical value in the cliagnose of double aortic arch,whether it is associated with other malformations and is important for assessing fetal prognosis.