超声断层显像技术诊断胎儿主动脉弓畸形

目的 探讨时空影像关联（STIC）技术结合超声断层显像（TUI）诊断胎儿主动脉弓异常的价值。方法 回顾性分析45胎主动脉弓畸形胎儿的产前超声资料。以二维超声心动图（2DE）于三血管-气管切面判断主动脉弓相对于气管的位置，寻找异常头臂动脉。以STIC技术采集容积数据后，分别在横断面及冠状面行TUI重建，于横断面TUI切面判断弓的位置；于冠状面TUI切面寻找迷走左、右锁骨下动脉及双侧主动脉弓汇合处。结果 45胎中，5胎双主动脉弓，9胎左位主动脉弓合并右锁骨下动脉迷走，31胎右位主动脉弓。STIC-TUI法及2DE对胎儿主动脉弓畸形的诊断率分别为97.78%（44/45）及71.11%（32/45），差异有统计学意义（P<0.01）。结论 STIC-TUI法可准确诊断胎儿主动脉弓畸形；标准化容积数据后处理方法使临床推广成为可能。

Prenatal diagnosis of aortic arch malformation using tomographic ultrasound imaging

Objective To explore the value of spatio-temporal image correlation (STIC) with tomographic ultrasound imaging (TUI) technique in diagnosis of fetal aortic arch malformation. Methods Ultrasonic data of 45 fetuses diagnosed as aortic arch malformation were reviewed retrospectively. Three-vessel and trachea view of 2D echocardiography (2DE) were used to analyze the aortic arch position in relation to the trachea, and to find the aberrant brachiocephalic arteries. Volume data were obtained, and TUI reconstruction was used to form transverse and coronal TUI slices to observe the arch position, the aberrant left or right subclavian arteries, the origin and convergence of bilateral aortic arches. Results Totally 5 fetuses of double aortic arch, 9 fetuses of left aortic arch with aberrant right subclavian arteries and 31 fetuses of right aortic arch were included. The accuracy rate of STIC-TUI in diagnosis of fetal aortic arch anomalies was significantly higher than that of 2DE (97.78%44/45] vs 71.11%32/45]; P<0.01). Conclusion Fetal aortic arch malformation can be accurately diagnosed using STIC-TUI, which can be widely used with standardized post-analysis in the future.