胎儿主动脉弓离断产前超声诊断分析  

Prenatal ultrasonic diagnosis of fetal interrupted aortic arch

作　　者：董莹[1] 王玲[1] 赵晟[1] 郭宁[1] 肖蕾[1] 

机构地区：[1]安徽医科大学第一附属医院超声科,合肥230022

出　　处：《中华超声影像学杂志》2014年第11期983-986,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨产前超声对胎儿主动脉弓离断（IAA）的诊断价值，分析漏、误诊原因，提高产前诊断率。方法回顾性分析16例胎儿主动脉弓异常超声图像特征，与正常胎儿超声图像、解剖结果进行对比研究，并分析胎儿1AA与染色体异常的相关性。结果16例产前诊断IAA病例，经解剖确诊15例，超声诊断正确率为94％（15／16），1例为主动脉弓严重缩窄（CoA），1例分型错误，3例产前超声不能分型病例获得明确分型，超声分型符合率为73％（11／15）。确诊的15例全部合并室间隔缺损，其中5例合并完全性心内膜垫缺损，合并心脏外畸形者9例。7例进行了染色体核型检查，3例18-三体，1例13一三体，3例正常，18-三体发生率为43％（3／7）。结论产前超声对胎儿IAA的诊断准确率高，但在明确分型方面有待提高。胎儿IAA与严重CoA的鉴别存在困难。18-三体在IAA胎儿染色体异常中发生率较高。Objective To evaluate the value of prenatal ultrasound in the interrupted aortic arch （IAA） ,and analyze the reasons of misdiagnosis and improve diagnostic ratio of this kind of defects.Methods Ultrasonic characteristics were analyzed in 16 fetuses with aortic arch anomalies,which were compared with ultrasound image and autopsy results of the normal fetus. The relativity of fetal IAA and abnormal chromosome was also analyzed.Results Among the 16 cases, 15 cases were confirmed by anatomy and the accuracy of ultrasound diagnosis was 94 ~/00 （15/16）, of which one case was serious constriction of aortic arch, one case was error type, three cases were obtained explicit type due to unsatisfactory results of prenatal ultrasound.The coincidence rate of ultrasonic type was 73 % （11/15）. All of the corrected diagnosed cases were detected with ventricular septal, of which 5 cases were detected with complete endocardial cushion defect,9 cases were found extra cardiac malformations. Among the 7 karyotype check cases,3 cases were diagnosed with Trisomy 18,1 case Trisomy 13 ,while the rest 3 cases normal.The incidence rate of Trisomy 18 was 43 %（3/7）.Conclusions Prenatal ultrasound shows a high accuracy in diagnosing fetal interrupted aortic arch （IAA）, but there＇s a need to be improved in explicit typing. It is difficult to identify fetal interrupted aortic arch （IAA） and serious constriction of aortic arch （COA）.The incidence rate of Trisomy 18 in the abnormal chromosome of fetal IAA is high.

关 键 词：超声检查 产前 胎儿 主动脉弓离断 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]