协和医学杂志

2016, (03)

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应用超声三血管气管切面诊断胎儿主动脉弓异常
The value of three-vessel tracheal view in the diagnosis of fetal aortic arch anomalies

欧阳云淑;张一休;孟华;姜玉新;戴晴;武玺宁;赵大春;刘欣燕

摘要(Abstract):

目的 研究超声三血管气管切面对于胎儿主动脉弓异常的诊断价值。方法 回顾性分析2010年5月至2014年5月北京协和医院诊断的17例胎儿主动脉弓异常的产前超声图像资料,并与产后超声及病理结果进行对照,分析不同类型主动脉弓异常的产前超声特征,重点关注三血管气管切面的表现。结果 17例主动脉弓异常在三血管气管切面均有阳性表现。其中主动脉弓缩窄3例,表现为主动脉弓细小;主动脉弓离断7例,表现为主动脉变细,不能连接至降主动脉;右位主动脉弓合并迷走左锁骨下动脉5例,可见环绕气管的“U”形血管环;右位主动脉弓合并镜像分支2例,可见主动脉弓位于气管右侧,动脉导管不汇入降主动脉。结论 三血管气管切面是提示胎儿主动脉弓异常敏感且有效的切面,中孕超声筛查时应重视该切面,早期发现异常并给予适当的遗传咨询。
Objective To investigate the diagnostic value of three-vessel and tracheal (3VT) view in fetal aortic arch anomalies. Methods Ultrasound findings of 17 fetuses with aortic arch anomalies diagnosed in Peking Union Medical College Hospital between May 2010 and May 2014 were reviewed and compared with the findings of postnatal ultrasonography and pathological examinations to analyze the ultrasound features of aortic arch anomalies of different types, focusing on the importance of 3VT view. Results In all 17 cases the 3VT view was abnormal. 3 cases were aortic coarctation, mainly manifested as reduced diameter of the aortic arch; 7 cases were interrupted aortic arch, in which there was discontinuity between the thinning aortic arch and the descending aorta; 5 cases were right aortic arch (RAA) with aberrant left subclavian artery, with a ‘U’-shaped vascular loop around the trachea; and 2 cases were RAA with mirror-image branching, with the aortic arch situated to the right of the trachea and not forming a V- or U-shaped confluence with the ductus.Conclusions The 3VT view is a very sensitive view to effectively diagnose fetal aortic arch anomalies. Meticulous ultrasound examination focusing on this view during second trimester may disclose the presence of such anomalies and help provide the appropriate genetic counselling.

关键词(KeyWords): |超声检查|胎儿|主动脉弓异常|三血管气管切面|
|Ultrasonography|Fetus|Aortic arch anomalies|Three-vessel tracheal view|

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基金项目(Foundation): 基于基层医院的胎儿孕早中期超声筛查方案的评价研究

作者(Author): 欧阳云淑;张一休;孟华;姜玉新;戴晴;武玺宁;赵大春;刘欣燕

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