胎儿双主动脉弓的产前超声心动图诊断

目的探讨双主动脉弓胎儿产前超声心动图特征及产前诊断临床意义。方法对南京医科大学附属苏州医院2012年1月至2013年2月产前超声心动图检出的5例双主动脉弓胎儿的超声心动图特征、分型及临床结局进行总结分析。结果5例双主动脉弓胎儿超声心动图表现：（1）三血管气管观中主动脉与动脉导管失去正常“V”字形结构,升主动脉发出左、右主动脉弓围绕气管,彩色多普勒血流成像示环状血流信号围绕气管。（2）超声心动图示5例胎儿中3例为右主动脉弓优势型,2例为左、右主动脉弓平衡型。（3）1例（例2）胎儿合并膜部室间隔缺损、永存左上腔静脉：1例（例4）胎儿合并半椎体畸形,3例胎儿未发现合并其他畸形。5例胎儿均行磁共振检查并随访至引产或产后3个月,随访检查均证实胎儿为双主动脉弓畸形。结论双主动脉弓是胎儿严重的先天性心脏病,超声心动图是产前首选的诊断方法,三血管气管观是诊断双主动脉弓的有效切面。     

右位主动脉弓胎儿超声心动图诊断分析

目的总结右位主动脉弓胎儿超声心动图表现及其血管特征.方法对26例超声心动图诊断为右位主动脉弓胎儿的超声心动图表现进行总结分析并观察其临床结局.结果26例右位主动脉弓胎儿中12例为孤立右位主动脉弓,2例为双主动脉弓,2例合并永存左上腔静脉,7例合并法洛四联症,3例合并永存动脉干.26例右位主动脉弓胎儿超声心动图均在上纵隔三血管气管观作出诊断.其中21例为右位主动脉弓合并迷走左锁骨下动脉、左位动脉导管,形成围绕气管食管的“U”字形血管环;2例双主动脉弓形成围绕气管食管的“O”字形血管环;3例无上述典型超声心动图图像特征.26例中12例活产儿经产后超声心动图或X线检查证实为右位主动脉弓;2例双主动脉弓经外院胎儿磁共振检查证实为右位主动脉弓;10例合并复杂先天性心脏病的胎儿均引产(6例尸体解剖检查证实为右位主动脉弓,4例未行尸体解剖检查);2例失访.结论胎儿右位主动脉弓有特征性超声表现,上纵隔三血管气管观可作为诊断胎儿右位主动脉弓的主要切面观;右位主动脉弓可孤立存在或同时合并其他心脏畸形.     

Right aortic arch in the fetus.

OBJECTIVE: To examine our experience of the detection of a right aortic arch in the fetus over an 8-year period. METHODS: Between February 1998 and December 2005, all patients prospectively diagnosed with a right aortic arch at our center were identified from our database and the videotape reviewed. In addition, the videotapes of 300 normal and 110 abnormal arbitrarily selected fetal echocardiograms, as well as 123 cases of tetralogy of Fallot and nine of a common arterial trunk were reviewed. Data including indication for fetal echocardiography, gestational age at diagnosis, karyotype, nuchal translucency measurement and outcome were collected. RESULTS: A right aortic arch was diagnosed prospectively in 55 fetuses and in a further 20 on retrospective videotape review. There were 21 examples of isolated aortic arch and four thought to have a double arch. A right arch was found in association with additional intracardiac malformations in 50 cases. The detection rate of a right aortic arch increased over the study period. The majority of patients were referred for a suspicion of congenital heart disease on obstetric scanning. Mean gestational age at diagnosis was 21 weeks. The karyotype including 22q11 status was known in 45/75 cases. There were 23 confirmed karyotypic anomalies, 12 of which were 22q11 deletions, occurring in 2/25 of the isolated group and 10/48 of the complex group, with a further two complex cases that were likely to have had 22q11 microdeletions. There were 29 pregnancy interruptions, four intrauterine deaths, 31 live births, four neonatal deaths and three patients lost to follow-up. The remaining four pregnancies are continuing. Of the four with suspected double arch, three were confirmed postnatally. CONCLUSION: The diagnosis of a right-sided aortic arch can be made by fetal echocardiography, either as an isolated lesion or in association with other cardiac malformations, from as early as 12 weeks' gestation. It can be difficult to distinguish from a double arch. Its increasing incidence over time in our series probably indicates that the diagnosis was previously overlooked. Karyotyping in the absence of other abnormal findings may be unnecessary in every case, but establishment of 22q11 microdeletion status in those cases with other anomalies is important.     

胎儿主动脉弓异常的超声诊断线索和方法研究

目的 探讨胎儿主动脉弓异常的超声诊断方法技巧、诊断线索,提高主动脉弓异常的产前超声诊断率.方法 选择2006年1月至2009年12月在我院行产前系统超声检查并获得结果验证的1472例正常和异常胎儿为研究对象,每个胎儿均进行四腔心切面、左右心室流出道切面、三血管气管切面的观察,当怀疑主动脉弓异常时,进一步获得主动脉弓长轴切面和冠状切面及经过气管的冠状切面.结果 产前超声共诊断148例主动脉弓异常,漏诊1例,92例获得结果验证,包括主动脉弓缩窄28例,主动脉弓离断10例,右位主动脉弓及主动脉弓分支异常52例,双主动脉弓2例.24例合并其他严重心脏畸形.主动脉弓缩窄、主动脉弓离断的线索为三血管气管平面均显示主动脉弓内径和动脉导管内径比例失调,主动脉弓内径异常小,四腔心切面显示左心小,左右心不对称;右位主动脉弓及其分支异常在3VTV平面显示主动脉弓位于气管右侧、主动脉弓和动脉导管之间距离增大呈"U"形和(或)在气管后方有发自降主动脉起始段的血管分支-锁骨下动脉.主动脉弓横切面即三血管气管切面、纵切面、冠状切面的显示率分别为 98.4%、90.0%、81.9%.结论 四腔心切面显示左心小,左右心不对称和3VT平面显示主动脉弓内径异常小,主动脉弓与动脉导管内径比例失调是诊断主动脉弓缩窄、离断的线索,主动脉弓和动脉导管之间距离增大是诊断右位主动脉弓的线索,三血管气管平面是诊断主动脉弓异常最易显示和最敏感的切面,主动脉弓冠状切面、纵切面及经过气管的冠状切面对诊断具有补充和鉴别意义.

Abstract：

Objective To study the ultrasonographic clues and methods for fetal anomalies of the aorta arch and improve prenatal detection of anomalies of the aorta arch.Methods One thousand four hundred and seventy-two cases fetus who were carried out detailed scan and whose results were confirmed were chose as study objects.Every routine fetal echocardiography included four chamber and left and right outflow tract and three-vessel trachea view(3VT).The more views which included longitudinal and coronary view of the aorta arch and coronary view of the trachea and main bronchus were obtained when the abnormality of aorta arch was suspected.Results One hundred and forty-eight cases with anomalies of aorta arch were diagnosed by ultrasonography.One case was misdiagnosed.Ninety-two fetus with anomalies of aorta arch which included 28 aortic coarctation(CoA) and 10 interrupted aortic arch (IAA) and 52 right-side aortic arch and abnormal aortic branch and 2 double aortic arch were confirmed by postmortem or postnatal echocardiography and surgery.Of the 92 confirmed cases,24 had prenatally diagnosed additional complex intracardiac anomalies.All cases with CoA and IAA presented ventricular and/or great arterial disproportion with smaller left ventricle and aorta diameter on four chamber view and 3VT.Right aortic arch (RAA) and abnormal aortic branch(AAB) displayed aortic arch located on the right side of the trachea and increased distance between the aortic arch and arterial duct and abnormal aortic arch branch-subclavian artery originating from the beginning section of the descend aorta which coursed behind the trachea with U-shaped appearance on the 3VT plane.The display rate of the transverse and longitudinal and coronary view of the aorta arch was 98.4%,90.0%,81.9%,respectively.Conclusions Disproportional ventricular and /or great arterial with smaller left ventricle and aorta diameter are the clues for CoA and IAA.Increased distance between the aortic arch and arterial duct is the clue for RSA.The transverse view of the aortic arch 3VT is the most sensitive for detecting the anomalies of the aortic arch and the most easily be obtained.The longitudinal and coronary view of the aorta arch and coronary view of the trachea and main bronchus are helpful in differentiating the anomalies of the aortic arch.     

胎儿右位主动脉弓的产前超声诊断

目的评价产前超声诊断胎儿右位主动脉弓的临床价值。方法回顾分析我院自2007年1月至2008年6月期间,产前超声诊断的7例胎儿右侧主动脉弓病例。结果产前超声诊断7例右主动脉弓病例。4例伴有左锁骨下动脉迷走,其中有一例产后诊断合并房间隔缺损,一例合并房间隔缺损及室间隔缺损。结论右主动脉弓可以在胎儿心超的三血管气管观上做出诊断。右主动脉弓可以单独发生,也可以合并其他心脏或心外畸形发生。     

超声心动图在双主动脉弓诊断及术后评价中的应用

目的 探讨超声心动图在双主动脉弓患儿术前诊断及术后评价中的作用.方法 回顾分析住院治疗的6例双主动脉弓患儿的临床及超声影像资料.结果 6例息儿中超声心动图诊断双主动脉弓4例,其中右弓占优势型3例,左右弓平衡型1例.平衡型双主动脉弓左侧主动脉弓和右侧主动脉弓内径基本相同,右弓占优势型的右侧主动脉弓内径明显大于左侧主动脉弓内径,左右侧主动脉弓上分别发出二支头臂动脉;超声心动图检查漏诊2例,均为左右弓平衡型.3例同时合并其他心内畸形.5例息儿手术治疗,术后最长随访时间为2年半.结论 超声心动图胸骨上窝切面显示无论是右位主动脉弓还是左位主动脉弓,当仅见二支头臂动脉发出时应高度警惕双主动脉弓的可能;超声心动图是双主动脉弓手术前后有效的无创检查方法.     

Aortopulmonary septal defect with interrupted aortic arch in a monochorionic diamniotic twin pregnancy

We report a monochorionic diamniotic twin pregnancy with prenatal diagnosis of aortopulmonary septal defect combined with type?B interrupted aortic arch in one of the fetuses. The mother was referred for fetal echocardiography at 24?weeks’ gestation due to suspected congenital heart disease. Prenatal echocardiography revealed a defect of 2.8?mm between the main pulmonary artery and the ascending aorta. The course of the ascending aorta was straight to the neck and head, and there was no continuity of the aortic arch after the origin of innominate and left common carotid arteries. Thus, aortopulmonary septal defect with type?B interrupted aortic arch was suspected. Postnatal echocardiography confirmed the diagnosis, and surgical repair was performed on the 10th day after birth. The combination of aortopulmonary septal defect with type?B interrupted aortic arch is a very rare condition that can be diagnosed by fetal echocardiographic examination in the second trimester of gestation. Prenatal diagnosis is important for the prognosis, since early surgical intervention is needed to prevent development of severe heart failure in the neonate.     

超声心动图诊断胎儿双主动脉弓的价值

目的探讨超声心动图诊断胎儿双主动脉弓的临床价值。方法 8例双主动脉弓胎儿,超声对各切面超声特点进行分析。结果超声心动图诊断胎儿双主动脉弓6例,5例为右弓稍大于左弓,1例为左右弓内径基本相同。1例胎儿同时合并其他心内畸形,核型分析为21-三体。左、右侧主动脉弓上分别发出两支头臂动脉。超声心动图漏诊2例,为左弓内径明显小于右弓。结论胎儿双主动脉弓在三血管-气管切面显示,由左弓和右弓包绕气管形成的完全血管环,左弓和右弓上均仅见两支头臂动脉发出。超声心动图对胎儿双主动脉弓早期检出具有重要的临床价值。     

胎儿主动脉弓发育异常产前超声诊断

目的 探讨胎儿主动脉弓发育异常的产前超声诊断价值。方法 回顾性分析45例胎儿主动脉弓发育异常产前超声图像特征。结果 经产后证实胎儿主动脉弓发育异常45例, 其中主动脉弓缩窄15例(13例合并心内畸形,6例合并心外畸形);主动脉弓离断3例(均合并心内畸形);右位主动脉弓并迷走左锁骨下动脉、左位动脉导管12例(1例合并心内畸形);镜面右位主动脉弓14例(7例合并心内畸形,4例合并心外畸形);双主动脉弓1例(未合并心内畸形)。结论 主动脉弓离断、主动脉弓缩窄、镜面右位主动脉弓常合并心内畸形,部分合并心外畸形,产前明确主动脉弓发育异常及其合并心内、心外畸形情况,对于评价胎儿预后有重要指导意义。     

产前超声诊断胎儿主动脉弓离断

目的 观察产前超声诊断胎儿主动脉弓离断(IAA)的价值，探讨胎儿IAA的病理演变过程。方法 回顾性分析经产前超声诊断(n=33)或引产后尸检证实(n=6)IAA的39胎胎儿超声心动图表现，并追踪其狭窄段主动脉演变情况。结果 39胎中，32胎产前超声诊断IAA,其中6胎主动脉缩窄(CoA)进行性加重，经超声心动图追踪复查诊断为IAA。其余7胎中，6胎产前超声误诊为主动脉弓病变，后均经尸检证实为IAA;1胎产前超声心动图显示左颈总动脉(LCA)与左锁骨下动脉(LSA)之间主动脉横弓无血流信号而误诊为B型IAA,经引产后尸检证实为LCA与LSA之间主动脉弓严重狭窄但未闭锁。38胎确诊IAA胎儿中，A型18胎、B型19胎、C型1胎；超声心动图表现主要为心脏四腔心切面左心室明显小于右心室或差别不明显，三血管切面主动脉明显小于肺动脉，三血管-气管切面和主动脉弓切面主动脉与降主动脉不相连，主动脉弓切面见主动脉弓弯曲度变小、走行僵直，主动脉、动脉导管及降主动脉之间无正常“V”字形结构；彩色多普勒显示主动脉弓中断处无连续血流信号，动脉导管内见血流反转。6胎最初产前超声心动图表现为CoA的IAA胎儿后经多...     

Bicuspid aortic valve with right-sided aortic arch aneurysm and Kommerell's diverticulum

Bicuspid aortic valve (BAV) is a common congenital cardiac malformation, frequently combined with ascending aorta dilation. However, isolated abnormalities of the aortic arch are less frequent in BAV patients. Here, we present a rare case of BAV combined with right-sided aortic arch aneurysm, aberrant left subclavian artery, and Kommerell's diverticulum, diagnosed by echocardiography and computed tomography angiography. The patient was followed-up regularly because of the life-threatening risks of aortic arch aneurysms.     

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。     

应用超声心动图对先天性主动脉弓畸形病例的分析

目的应用超声心动图观察分析先天性主动脉弓畸形的类型。方法回顾分析以往病例检查中31例先天性主动脉弓畸形患者的超声心动图表现。所选病例均经手术或心血管造影(CAG)证实。结果31例先天性主动脉弓畸形患者中,右位主动脉弓(RAA)18例(2例伴有椎动脉自主动脉弓发出),主动脉缩窄(COA)5例,主动脉弓部曲折畸形3例,单纯头臂干(无名动脉)发出异常2例,肺动脉单发于主动脉弓2例(1例伴有头臂干发出异常),主动脉弓离断(IAA)1例,其中27例合并其他心内畸形。结论超声心动图对于诊断先天性主动脉弓畸形是一种有效、无创、经济的检查手段,可作为诊断的首选方法。     

复杂主动脉弓畸形的超声诊断

目的 探讨复杂主动脉弓畸形的超声表现及误、漏诊原因.方法 回顾性分析15例少见主动脉弓畸形的超声图像,包括主动脉弓离断9例、双主动脉弓1例、右位主动脉弓伴左侧动脉导管未闭3例、永存第五对主动脉弓2例.所有病例均经CT检查及术中发现证实.结果 15例患者的超声诊断中,主动脉弓离断1例漏诊(1/9),双主动脉弓1例漏诊(1/1),右位主动脉弓伴左侧动脉导管未闭1例误诊(1/3),永存第五对主动脉弓1例误诊(1/2)、1例漏诊(1/2),其余术前超声均获得正确诊断.结论 超声心动图对主动脉弓离断能做出较准确诊断,但对双主动脉弓、右位主动脉弓合并左侧动脉导管未闭及永存第五对主动脉弓等几类畸形易误诊或漏诊,增强认识并仔细扫查有望提高超声检出率.     

Anomalies of the fetal aortic arch: a novel sonographic approach to in-utero diagnosis.

OBJECTIVE: To describe a novel, sonographic approach for in-utero evaluation of normal and abnormal aortic arch. METHODS: Aortic arch was evaluated by imaging of the axial view of the upper fetal mediastinum. The normal left aortic arch was defined by the V-shaped appearance of the junction between the ductus arteriosus and aortic arch, with the trachea situated posteriorly. Right and double aortic arches were diagnosed when the great vessels appeared U-shaped, with intermediate location of the trachea. RESULTS: Between 1997 and 1999, 18 347 women were scanned in three prenatal centers, and pathological findings were prospectively recorded. In a retrospective analysis of the records, we identified 19 fetuses (0.1%) with atypical, U-shaped appearance, and no other structural abnormalities present. With the exception of one fetus with a ventricular septal defect, no congenital cardiac defects were present. Right aortic arch was found in 18 cases, while color Doppler made it possible to diagnose one case with double aortic arch, and one fetus was demonstrated as having Kommerell's diverticulum. In all 18 cases, a left descending aorta and left ductus arteriosus were present, the latter coursing to the left of the trachea, forming a loose partial vascular ring. All were asymptomatic at birth and early infancy. The fetus with double aortic arch that had a true vascular ring underwent early infantile correction. CONCLUSIONS: It is possible to diagnose right and double fetal aortic arch using prenatal ultrasound. The use of color Doppler facilitated in-utero evaluation of possible complications, such as true vascular ring.     

超声心动图诊断主动脉缩窄合并主动脉弓发育不良的价值

目的 探讨超声心动图诊断主动脉缩窄合并主动脉弓发育不良的准确性.方法 分析7例主动脉缩窄合并主动脉弓发育不良患儿的二维超声图像,并与心血管造影,心脏CT及手术结果对比分析,总结其诊断要点.结果 除主动脉缩窄的超声表现外,超声特异表现为:胸骨上凹主动脉弓长轴切面可见主动脉横弓部及弓降部明显变窄.发育不良的范围可自无名动脉起始后或左颈总动脉起始后;发育不良主动脉弓的内径/膈肌处降主动脉胸段的内径<0.5;多普勒测定主动脉缩窄处血流速度均在正常范围.超声诊断均与心血管造影、心脏CT及手术结果相符.结论 超声心动图诊断丰动脉缩窄合并主动脉弓发育不良具有较高的准确性,在主动脉缩窄的诊断中.应提高对合并主动脉弓发育不良的认识.     

动脉导管弓与主动脉弓间距及夹角在胎儿右位主动脉弓诊断中的应用价值

目的探讨胎儿超声心动图三血管气管（3VT）切面定量测量动脉导管弓与主动脉弓之间的距离与夹角在胎儿右位主动脉弓（RAA）诊断中的应用价值。 方法选取单纯RAA左位动脉导管胎儿52例作为研究组（RAA组）,随机选取正常胎儿121例作为对照组,分别测量2组胎儿超声3VT切面上动脉导管弓与主动脉弓内径及两者之间的间距与夹角（AP角）,将RAA组与对照组间的各超声测量参数进行统计学分析。 结果RAA组与对照组比较,动脉导管弓与主动脉弓之间间距增大［4.86（4.16~5.74）mm vs 1.59（1.38~1.76）mm］,AP角减小［（12.96±1.83）° vs（22.14±1.35）°］,差异均有统计学意义（Z=-10.416、P<0.05,t=32.481、P<0.05）;RAA组与对照组的动脉导管弓内径、主动脉弓内径、动脉导管弓/主动脉弓内径比值、主动脉内径、肺动脉内径、主动脉流速、肺动脉流速比较,差异均无统计学意义（P均>0.05）。2组的AP角、动脉导管弓/主动脉弓内径比值与孕周均无相关性（RRA组：r=0.148、0.029,P=0.294、0.818;对照组：r=0.060、0.108,P=0.514、0.180）。2组的动脉导管弓与主动脉弓间距、动脉导管弓内径、主动脉弓内径、主动脉内径、肺动脉内径、主动脉流速、肺动脉流速均与孕周呈线性正相关（P均<0.05）。 结论胎儿超声心动图3VT切面测量动脉导管弓与主动脉弓间距及夹角的方法简单可行,能够为胎儿RAA左位动脉导管的诊断提供更为准确的定量参考,具有一定的临床应用价值。     

产前超声检查胎儿右位主动脉弓的诊断价值及分析

目的 探讨产前超声诊断胎儿右位主动脉弓的诊断价值,以提高产前诊断率。方法 回顾性总结在我院产前超声诊断的33例右位主动脉弓胎儿的超声资料及随访结果,并对产 后超声心动图检查或引产后尸检结果进行比较,对其超声特征进行总结分析。结果 33例产 前诊断的胎儿右位主动脉弓病例,19例为单纯性右位主动脉弓,10例伴有其他心内畸形,4 例伴有心外畸形,所有病例均在三血管气管切面上有异常图像,且随访结果均证实存在右位 主动脉弓。结论 产前超声检查对诊断右位主动脉弓具有明确诊断价值,三血管气管切面是 超声诊断胎儿右位主动脉弓的重要切面,具有特征性表现,扫查时需注意血管走行,避免漏 诊误诊。     

主动脉弓降部异常的超声诊断

目的　提高超声对主动脉弓中断 (IAA)、主动脉缩窄 (CoA)、右位主动脉弓 (RAA )三类主动脉弓降部异常的诊断能力。方法　回顾性分析 5 2例主动脉弓降部异常患者的胸前及胸骨上窝二维及多普勒超声表现。结果　IAA表现为主动脉弓部成为盲端 ,降主动脉与肺动脉相连 ,最常合并室间隔缺损 ,均有重度肺高压等。CoA表现为主动脉峡部狭窄 ,降主动脉常窄后扩张 ,腹主动脉内血流频谱异常等 ,部分无心内畸形 ,可通过胸骨上窝及心内表现不同与IAA加以鉴别。RAA表现为主动脉弓弯向右侧 ,标准切面观察时与IAA相似。大部分合并复杂畸形。结论　超声心动图对于诊断主动脉弓降部异常是一种有效、无创、经济的检查手段。胸骨上窝切面超声表现是诊断本病的关键 ,有必要作为常规检查切面     

主动脉弓缩窄的产前超声诊断

目的探讨胎儿主动脉弓缩窄(CoA)的产前超声诊断线索、诊断方法与技巧及畸形特征。方法所有胎儿均常规获得四腔心切面、左右心室流出道切面、三血管气管(3VT)切面(即主动脉弓横切面)的灰阶和彩色多普勒血流显像。当四腔心切面发现左心系统偏小、3VT切面显示主动脉弓和动脉导管内径比例失调疑CoA时,进一步获得主动脉弓纵切面和冠状切面(Y平面)并测量峡部内径。结果产前超声共诊断56例CoA患儿,28例有解剖或新生儿超声心动图和手术结果,产前超声误诊和漏诊4例。其中8例合并单心室、心内膜垫缺损、右心室双出口、大动脉转位、永存动脉干等其他严重复杂心脏畸形,7例合并心脏外严重畸形。22例合并室间隔缺损(VSD)和永存左上腔静脉(LSVC)等非复杂心脏畸形。产前超声诊断的28例CoA患儿均首先于3VT切面发现两大动脉内径比例失调,主动脉弓异常小,四腔心切面显示左、右心室比例不对称,左心明显小于右心。此28例CoA患儿中有23例(82.1%)同时获得了3VT切面、主动脉弓纵切面及Y平面,14例于主动脉弓纵切面显示有来自降主动脉的反流。而误诊和漏诊的4例CoA患儿均未能获得满意的主动脉弓纵切面和Y平面。结论 3VT切面显示主动脉弓和动脉导管内径比例失调和四腔心切面不对称、左心偏小是CoA的诊断线索,进一步获取主动脉弓的特殊切面以获得至少2个平面的印证是提高CoA产前诊断率的主要技巧。CoA可以单独发生,也可合并其他心内外畸形。