产前超声预警征象对胎儿主动脉缩窄的诊断价值

Prenatal Ultrasonic Early Warning Sign for the Diagnosis of Coarctation of the Aorta

目的探讨产前超声诊断预警征象对胎儿主动脉缩窄(COA)的诊断价值。资料与方法回顾性分析21例COA胎儿的临床及影像学资料,根据随访与产前诊断结果分为真阳性组及假阳性组,比较两组胎儿临床资料、超声图像及相关测量参数。结果真阳性组10例,假阳性组11例,真阳性率为47.6%。真阳性组与假阳性组胎儿首次诊断孕周[(25.10±3.38)周比(28.82±2.82)周,P=0.013]、三血管切面升主动脉与上腔静脉比值(RAAO/SVC)(0.94±0.08比1.10±0.10,P=0.001)及冠状切面动脉导管与主动脉峡部连接“Y”征显示率(20.0%比90.9%,P=0.005)差异均有统计学意义。右心室与左心室横径比值(1.28±0.21比1.38±0.19,P=0.280)及肺动脉与升主动脉比值(1.81±0.44比1.58±0.22,P=0.126)差异均无统计学意义。结论预警征象联合孕周因素、RAAO/SVC比值及冠状切面“Y”征显示有助于降低胎儿COA诊断的假阳性率。

Purpose To explore the value of early warning signs related to coarctation of the aortic(COA)in prenatal diagnosis with ultrasonography.Materials and Methods The clinical and imaging data of 21 fetuses with COA were retrospectively analyzed.The pregnancy outcome was followed up and divided into true positive group and false positive group.The fetal clinical data,ultrasound images and related measurement parameters of the two groups were compared.Results There were 10 cases in true positive group and 11 cases in false positive group,the true positive rate was 47.6%.First diagnosis of gestational age[(25.10±3.38)weeks vs.(28.82±2.82)weeks,P=0.013].RAAO/SVC in three-vessel view(0.94±0.08 vs.1.10±0.10,P=0.001),display rate of"Y"sign between DA and AI in coronary section(20.0%vs.90.9%,P=0.005)showed statistical difference between the two groups.RRV/LV(1.28±0.21 vs.1.38±0.19,P=0.28)and ratio of pulmonary artery to ascending aorta(1.81±0.44 vs.1.58±0.22,P=0.126)showed no statistical difference between the two groups.Conclusion It is helpful to reduce the risk of false positive when early warning signs take gestational weeks,RAAO/SVC and the"Y"sign in coronal section into account.