胎儿右位主动脉弓及合并畸形的超声诊断分析  

Ultrasonic diagnosis and analysis on fetal right aortic arch and associated cardiac abnormalities

作　　者：王新霞[1] 栗河舟[1] 王铭[1] 刘云[1] 吴娟[1] 林杉[1] 

机构地区：[1]郑州大学第三附属医院超声科,河南郑州450052

出　　处：《中国妇幼保健》2015年第6期922-924,共3页Maternal and Child Health Care of China

基　　金：河南省教育厅科学技术研究重点项目〔14A320025〕;河南省卫生厅科技攻关项目〔142102310499〕

摘　　要：目的：分析胎儿右位主动脉弓的超声心动图特征以及合并畸形情况。方法：回顾性分析2012年5月～2013年5月该院产前超声诊断为右位主动脉弓的102例胎儿的超声心动图特征及合并畸形情况。结果：102例右位主动脉弓胎儿中有99例（97.1%）合并左位动脉导管,形成围绕气管的U字形血管环;3例（2.9%）合并右位动脉导管,未能形成血管环。68例（66.7%）为孤立性右位主动脉弓,24例（23.5%）仅合并心内结构畸形,5例（4.9%）同时合并心内及心外结构异常。孤立性右位主动脉弓中38例活产儿经产后超声心动图或CT检查证实为右位主动脉弓,准确率达100.0%;17例合并复杂先天性心脏病及6例合并心外结构畸形的胎儿选择终止妊娠。结论：右位主动脉弓可通过产前超声诊断;右位主动脉弓多合并左位动脉导管,较少合并右位动脉导管;孤立性右位主动脉弓预后较好,合并心内或心外畸形时视畸形类型判断预后,合并心外畸形无明显特异性。Objective： To analyze echocardiographic characteristics of fetal right aortic arch （RAA） and associated cardiac abnor- malities. Methods： Echocardiographic characteristics of fetal RAA and associated cardiac abnormalities of 102 fetuses diagnosed as RAA during prenatal examination in the hospital from May 2012 to May 2013 were analyzed retrospectively. Results： Among 102 fetuses with RAA, 99 fetuses （97. 1% ） were found with left ductusarteriosus, U -shaped vascular ring around trachea was formed; 3 fetuses （2. 9% ） were found with right ductus arteriosus, no vascular ring was formed; 68 fetus （66.7%） were found with isolated RAA; 24 fetus （23.5%） were found with intracardiac structural anomalies; 5 fetus （4. 9% ） were found with intracardiac and extracardiac structural anomalies. A- mong the fetuses with isolated RAA, 38 live births were confirmed as RAA by echocardiogram or CT scan after birth, the accurate rate was 100. 0% ; termination of pregnancy was performed among 17 cases with complex congenital heart diseases and 6 cases with extracardiac struc- tural anomalies. Conclusion： RAA can be diagnosed by prenatal ultrasonography. RAA is always associated with left duct arteriosus, right duct arteriosus is few. Isolated RAA always has a good prognosis. The prognosis of RAA combined with intracardiac or extracardiac structural anomalies depends on types of anomalies, RAA combined with extracardiac structural anomalies has no significant specificity.

关 键 词：右位主动脉弓 产前诊断 胎儿 三血管气管观 

分 类 号：R540.45[医药卫生—心血管疾病]