产前超声三血管多切面和主动脉冠状及矢状切面诊断胎儿先天性血管环

Three-vessel multi-section and aortic coronal and sagittal section of prenatal ultrasound for diagnosis of fetal congenital vascular ring

目的观察产前超声三血管多切面和主动脉冠状及矢状切面诊断胎儿先天性血管环的价值。方法回顾性分析42胎经产前超声诊断的先天性血管环胎儿,于超声三血管多切面、主动脉冠状及矢状切面观察上腔静脉、主动脉弓、肺动脉及动脉导管与气管的位置关系等,并结合产后随访结果分析各切面用于诊断胎儿先天性血管环的价值。结果42胎中,19胎为右位主动脉弓,其中16胎为右位主动脉弓+迷走左锁骨下动脉+左侧动脉导管,3胎为右位主动脉弓伴镜像分支+左侧动脉导管;17胎为左位主动脉弓伴迷走右锁骨下动脉;3胎为双主动脉弓,其中2胎为右弓优势型、1胎为均衡型;3胎为肺动脉吊带。15胎合并心内畸形。8名孕妇因胎儿染色体异常终止妊娠,9名孕妇于外院分娩而失访;25例新生儿超声心动图或CTA所见均与产前检查结果相符。结论产前超声三血管多切面结合主动脉冠状及矢状切面有助于检出胎儿先天性血管环。

Objective To observe the value of three-vessel multi-section,aortic coronal and sagittal section of prenatal ultrasound for diagnosing fetal congenital vascular ring.Methods Data of 42 fetuses diagnosed as congenital vascular ring with prenatal ultrasound were retrospectively analyzed.The position relationships of superior vena cava,aortic arch,pulmonary artery,arterial catheter with trachea were observed on three-vessel multi-section,aortic coronal and sagittal section of ultrasonography,and the value of each section for diagnosing fetal congenital vascular ring was analyze compared with the outcomes of postpartum imaging follow-up.Results Right aortic arch was found in 19 fetuses,including right aortic arch+vagal left subclavian artery+left arterial catheter in 16 and right aortic arch and mirror branch+left arterial catheter in 3 fetuses.Left aortic arch and vagal right subclavian artery were detected in 17 fetuses,3 fetuses were found with double aortic arch,including 2 with dominant type of right arch and 1 with balanced type,and 3 fetuses were found with pulmonary artery sling.Complicated intracardiac malformations were observed in 15 fetuses.Eight pregnant women terminated pregnancy due to fetal chromosomal abnormalities,9 gave birth outside hospital and were lost during follow-up.The findings of postpartum echocardiography or CT angiography(CTA)of rest 25 newborns were consistent with those of prenatal examination.Conclusion Three-vessel multi-section and aortic coronal and sagittal section of prenatal ultrasound were helpful to detecting fetal congenital vascular ring.