超声心动图诊断胎儿右位主动脉弓及预后评估  

Echocardiographic diagnosis of fetal right aortic arch and prognosis evaluation

作　　者：廖林[1] 魏俊[2] 罗友[1] 项莉亚[1] 

机构地区：[1]成都市西区医院产科,四川成都610036 [2]重庆市妇幼保健院超声科,重庆400013

出　　处：《中国医学影像技术》2016年第4期582-585,共4页Chinese Journal of Medical Imaging Technology

基　　金：重庆市卫生局面上项目(2010-2-327)

摘　　要：目的探讨超声心动图诊断胎儿右位主动脉弓(RAA)及其在预后评估中的应用价值。方法回顾性分析经超声心动图诊断为胎儿RAA的25名单胎孕妇资料。7胎引产终止妊娠,对其中4胎进行胎儿尸体检查。对18胎继续妊娠者,于产后1个月内对患儿行超声心动图、MR或CT检查,并临床随访半年,观察患儿有无反复发作的气管或食管受压症状。结果 19胎为RAA伴左位动脉导管、迷走左锁骨下动脉,4胎为RAA伴头臂动脉镜像分支(3胎伴右位动脉导管、1胎伴左位动脉导管),2胎为双主动脉弓。18胎为单纯性RAA,余7胎合并其他心内外畸形,且包括2胎染色体异常。4胎经尸体检查证实为RAA。18胎出生后经超声心动图、MR或CT检查证实为RAA患儿,且出生后半年内15例患儿无明显气管或食管受压症状,3例出现反复发作的慢性咳嗽、气喘,吞咽困难,经抗感染治疗后症状缓解。结论超声心动图是诊断胎儿RAA的可靠方法;胎儿RAA的预后主要与是否并发其他心内外畸形或染色体异常有关。Objective To explore the application value of echocardiographic diagnosis of fetal right aortic arch（RAA）and prognosis evaluation.Methods Datum of 25 pregnant women with RAA fetal confirmed by echocardiography were retrospectively analyzed.Seven fetuses were induced abortion,and 4fetuses autopsy were carried out among them.For 18 fetuses continuously conceived,echocardiography,MR or spiral CT examination was performed during 1months after the birth of the fetus,and clinically followed-up was last for six months in order to observe the fetus if had repeated episodes of trachea or esophagus press.Results Nineteen fetuses were RAA with left duct artefiosus and aberrant left subclavicular artery;4fetuses were RAA with brachiocephalic artery mirror branch（3fetuses with right duct artefiosus,1fetuse with left duct artefiosus）;2fetuses with double aortic arch.Eighteen fetuses were simple RAA;7fetuses combined with other intracardiac and exocardial malformations,including 2fetuses of abnormal chromosome.Four fetuses were confirmed as RAA by autopsy.Eighteen fetuses were confirmed as RAA by echocardiography,MRI or CT,of which 15 cases had no obvious symptoms of tracheal or esophageal press symptom in the six months after birth;3cases had chronic cough,wheezing,dysphagia,whose symptoms were relieved after anti-inflammatory treatment.Conclusion Echocardiography is a reliable method for the diagnosis of RAA;the prognosis of RAA is mainly related to if combines other intracardiac and exocardial malformations or abnormal chromosome.

关 键 词：胎儿 右位主动脉弓 超声心动描记术 三血管-气管切面 

分 类 号：R541.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]