超声心动图不同切面诊断胎儿先天性血管环的价值

Value of Different Sections of Echocardiography in the Diagnosis of Fetal Congenital Vascular Ring

目的分析超声心动图不同切面诊断胎儿先天性血管环(CVR)的价值。方法回顾性分析2018年1月至2021年1月于云南大学附属医院产前诊断的60例CVR超声心动图资料和随访结果,重点观察三血管气管切面(3VT)、弓降部冠状切面、三血管肺动脉分支切面,总结CVR在3VT、弓降部冠状切面、三血管肺动脉分支切面的声像图特点。对比CVR在3VT、3VT+弓降部冠状切面、3VT+弓降部冠状切面+三血管肺动脉分支切面诊断情况。结果60例超声心动图诊断的CVR中,经过引产后病理解剖、产后超声心动图、CT或MRI随访结果证实:共59例确诊为CVR(准确率98.3%),1例误诊(误诊率1.7%)。3VT+弓降部冠状切面+三血管肺动脉分支切面诊断率高于3VT及3VT+弓降部冠状切面(P<0.05),3VT+弓降部冠状切面诊断率高于3VT(P<0.05)。结论3VT+弓降部冠状切面+三血管肺动脉分支切面是诊断胎儿CVR的重要切面,诊断符合率高,具有重要的临床应用价值。

Objective To analyze the diagnostic value of different sections of echocardiography in fetal congenital vascular ring(CVR).Methods The echocardiography data and follow-up results of 60 cases of CVR diagnosed in Yunnan University Hospital from January 2018 to January 2021 were retrospectively analyzed.The three vessel trachea section(3VT),the descending arch coronal section and the three vessel pulmonary artery branch section were observed.The ultrasonographic characteristics of CVR in 3VT,coronal section of descending arch and three-vessel pulmonary artery branch were summarized.The diagnosis of CVR in 3VT,3VT+descending arch coronal section,3VT+descending arch coronal section+three-vessel pulmonary artery branch section was compared.Results Among 60 cases of CVR diagnosed by echocardiography,59 cases were confirmed to be CVR(accuracy rate 98.3%),and 1 case was misdiagnosed(misdiagnosis rate 1.7%),which was confirmed by pathological autopsy after labor induction,postpartum echocardiography,CT or MRI follow-up.The diagnostic rate of 3VT+descending arch coronal section+three-vessel pulmonary artery branch section was higher than that of 3VT and 3VT+descending arch coronal section(P<0.05),and the diagnostic rate of 3VT+descending arch coronal section was higher than that of 3VT(P<0.05).Conclusion 3VT+coronal section of descending arch+threevessel section of pulmonary artery branch is an important section for the diagnosis of fetal CVR,with high diagnostic accuracy and important clinical application value.