胎儿右位主动脉弓的产前超声诊断分析

Prenatal ultrasound diagnosis of fetal right aortic arch

目的探讨产前超声诊断胎儿右位主动脉弓的临床应用价值。方法回顾性分析13例经产前超声检查诊断为右位主动脉弓的胎儿的临床资料,分析产妇产前以及随访产后超声检查结果。结果右位主动脉弓共13例,12例伴左锁骨下动脉迷走和左位动脉导管,1例未显示清晰左锁骨下动脉。有1例合并完全性房室间隔缺损及其他复杂畸形引产,1例因染色体异常引产。11例胎儿顺利出生后,产前超声复查和(或)产后超声复查或CT检查结果与产前超声筛查一致。且分别接受了胎儿出生后时间不同的各一次随访,1例在出生因出现缺氧症状,曾外院接受手术治疗,后来情况一直稳定;另10例未曾发现受压所致的其他明显不适症状,未采取外科手术治疗。结论胎儿右位主动脉弓在分娩前有特征性的超声表现,3VT切面对诊断右位主动脉弓非常关键,产前超声是诊断右位主动脉弓方便可行的方法,值得推广应用。

Objective To discuss the clinical value of prenatal ultrasound diagnosis of fetal right aortic arch.Methods The clinical data of 13 fetuses diagnosed as right aortic arch by prenatal ultrasound examination were analyzed retrospectively,and the results of prenatal and follow-up ultrasound examinations were analyzed.Results There were 13 cases of right aortic arch,12 cases of them were accompanied by left subclavian artery vagal and left artery catheter,and 1 case did not show left subclavian artery clearly.1 case was induced due to combined complete atrioventricular septal defect and other complicated deformities,and 1 case was induced due to chromosomal abnormalities.After 11 fetuses was delivered successfully,thr results of prenatal ultrasound and/or postnatal ultrasound or CT examination were consistent with those of prenatal ultrasound screening.and they were followed up at different times after birth.1 case had hypoxic symptoms at birth and had undergone surgery outside the hospital,and the condition remained stable.The other 10 cases had no other obvious discomfort symptoms caused by compression and did not undergo surgical treatment.Conclusion The fetal right aortic arch has characteristic ultrasound manifestations before delivery.The 3 VT incision is very important in diagnosing the right aortic arch.Prenatal ultrasound is a convenient and feasible method for diagnosing the right aortic arch and is worthy of popularization and application.