超声心动图对小儿主动脉弓离断及分型的诊断价值

目的探讨超声心动图对小儿主动脉弓离断（IAA）及分型的诊断价值。方法总结、分析38例IAA的超声心动图资料，并与手术及心血管造影结果进行对照分析。结果手术及心血管造影证实38例IAA，其中IAA-A型、IAA-B型、IAA-C型所占比例分别为57.9％（22/38）、36.8％（14/38）、5.3％（2/38）。新生儿期确诊81.6％（31/38），其中15.8%（6/38）产前超声检查发现。超声检查将IAA误诊为重度、极重度主动脉弓缩窄（COA）3例。超声检查确诊病例中IAA分型正确率为80.0%（28/35）。38例IAA患儿均合并重度肺动脉高压和动脉导管未闭，其中合并房间隔缺损或卵圆孔未闭37例，各种类型的室间隔缺损35例，主肺动脉窗3例。结论超声心动图能早期确诊IAA，同时能清晰显示其分支并明确分型，还能诊断合并症，从而可提高胎儿及新生儿先天性心脏大血管畸形的诊断率，为外科手术提供全面有效的依据。

Value of echocardiography for diagnosis of interrupted aortic arch in children

Objective To assess the value of echocardiography in the diagnosis of interrupted aortic arch(IAA) in children. Methods The echocardiographic images of 38 pediatric patients with IAA diagnosed by surgical and angiographic findings were analyzed. Results Among the 38 cases with IAA, 35 cases were diagnosed by echocardiography correctly, in which 22 cases (57.9%) were classified as type A, 14(36.8%) as type B, and 2(5.3%) as type C; 31 cases were diagnosed during neonatal period, while 6 cases were identified during prenatal period. The accurate rate of typing was 80.0% (28/35) among patients diagnosed by echocardiography. All cases were associated with patent ductus arterioses and pulmonary hypertension, while 37 cases were complicated with atrial septal defect or patent foramen ovale, 35 cases were complicated with ventricular septal defect, and 3 with aorto-pulumonary windows. Conclusion The pediatric echocardiography is of great value in early diagnosis of IAA during neonatal or prenatal period, and can provide effective evidence for surgery.