胎儿右位主动脉弓的产前超声诊断及分析

目的提高胎儿右位主动脉弓的产前超声诊断正确率。方法分析总结我院诊断的51例右位主动脉弓胎儿产前超声特征。结果 51例右位主动脉弓胎儿中,右位主动脉弓并左锁骨下动脉迷走30例(其中右位主动脉弓并左无名动脉迷走1例),镜面右位主动脉弓21例。单纯右位主动脉弓24例,合并复杂心内外结构畸形24例(镜面右位主动脉弓19例),形成血管环29例。结论不同类型的胎儿右位主动脉弓有不同的结构特点,并有其特殊的产前超声表现,部分镜面右弓和右位主动脉弓并动脉迷走时在产前诊断仍有一定的难度。

Prenatal ultrasonic diagnosis and analysis on fetal right aortic arch

Objective To improve the prenatal echocardiographic diagnostic accuracy for fetus with right aortic arch(RAR).Methods Echocardiographic signs were analyzed and summariedd in 65 cases with prenatal diagnosis of right aortic arch between January 2014 and December 2017. Results Among 65 fetuses with RAR, 35 cases were RAR with aberrant left subclavian artery(1 case was RAR with aberrant left innominate artery),27 cases were mirror-image RAR, 3 cases were double aortic arches. RAR could be alone or with complex intracardiac and extracardiac abnormalities. The morbidity of RAR with aberrant left subclavian artery was higher than other types, and RAR with aberrant left subclavian artery was rarely combined complex intracardiac abnormalities.The position of the ductus arteriosus was different between different types of RAR.Part of the RAR could form vascular ring. Conclusion Different types of RAR have different structural characteristics, and have the characteristic fetal echocardiographic features, it has certain difficulty to prenatal diagnosis part of mirror-image RAR and RAR with aberrant artery.