主动脉弓左侧分支追踪法诊断胎儿右位主动脉弓与双主动脉弓

Diagnosis of Fetal Right Aortic Arch and Double Aortic Arch by Tracking the Left Branch of the Aortic Arch

目的探讨主动脉弓左侧分支追踪法诊断胎儿右位主动脉弓与双主动脉弓的价值。资料与方法纳入60例主动脉弓畸形胎儿,于三血管-气管(3VT)切面均探及“U”形环结构。传统横断面扫查法在3VT切面上诊断主动脉弓畸形。追踪法在3VT切面基础上寻找从主动脉弓向左侧发出的血管,观察其走行并作出诊断。结果经尸检或产后超声心动图证实共5例双主动脉弓,46例右位主动脉弓合并左锁骨下动脉迷走,9例右位主动脉弓合并左无名动脉。传统扫查方法与追踪法对胎儿主动脉弓畸形的诊断率分别为63.33%、96.67%,差异有统计学意义(X^2=20.83,P<0.01)。结论追踪主动脉弓左侧分支法可以有效地诊断不同类型的右位主动脉弓及双主动脉弓,方法简单,提高了主动脉弓畸形的检出率。

Purpose To investigate the value of the left branch of the aortic arch in the diagnosis of fetal right aortic arch and double aortic arch.Materials and Methods Sixty fetuses with aortic arch malformations were enrolled in this study,and the"U"ring structure was explored on the three-vessel and trachea(3VT)view.The traditional cross-section scan was used to diagnose aortic arch deformity on the 3VT section.In addition,another examiner traced the left branch of the aortic arch to diagnose right aortic arch or double aortic arch.Results Five cases of double aortic arch were confirmed by autopsy or postpartum echocardiography,46 cases of right aortic arch and aberrant left subclavian artery,and 9 cases of right aortic arch and left innominate artery.The diagnosis rates of fetal aortic arch deformity by traditional scanning and tracking methods were 63.33%and 96.67%,respectively,with statistically significant difference(X^2=20.83,P<0.01).Conclusion The method of tracking the left branch of the aortic arch can effectively diagnose different types of right aortic arches and double aortic arches.The method is simple and improves the detection rate of aortic arch malformations.