产前超声诊断胎儿右位主动脉弓并右位动脉导管

目的探讨产前超声诊断胎儿右位主动脉弓并右位动脉导管的价值。方法回顾分析11胎右位主动脉弓并右位动脉导管的胎儿超声心动图特征,重点观察三血管气管切面主动脉弓与肺动脉动脉导管的连接形态、主动脉弓和动脉导管与气管的位置关系。结果右位主动脉弓并右位动脉导管时,主动脉弓和动脉导管均位于气管的右侧,呈反向的"V"型连接,即主动脉弓和动脉导管仍呈"V"型连接,但位于气管的右侧。所有11胎右位主动脉弓并右位导管胎儿均不伴迷走左锁骨下动脉,未形成血管环。结论胎儿右位主动脉弓并右位导管的诊断切面为三血管气管切面,但不表现为右位主动脉弓并左位导管时特征性的"U"型连接,诊断的关键在于仔细观察主动脉弓和动脉导管与气管的位置关系。

Prenatal echocardiographic diagnosis of fetal right-sided aortic arch and right-sided ductus

Objective To explore the value of prenatal echocardiography in diagnosis of fetal right-sided aortic arch and right-sided ductus (RAARD). Methods Echocardiographic features of 11 fetuses of RAARD were analyzed retrospectively. Focus was put on the observation of the connection patterns and relationship of aortic arch and ductus with the trachea on the three-vessel and trachea (3VT) view. Results The echocardiographic features of RAARD was that the aortic arch and ductus both located on the right side of trachea in the 3VT view. The connection pattern was the V-shape located on the right side of the trachea. All the cases had no aberrant left subclavian arteries, thus no vascular ring detected. Conclusion The 3VT view is the key plane to detect the RAADA, which connection pattern of aortic arch and ductus is not the traditional U-shape which can be seen at right-sided aortic arch and left-sided ductus. Therefore, the key of the diagnosis is the observation of the relationship of aortic arch and ductus with the trachea on 3VT view.