产前超声诊断右位主动脉弓及其分支类型的价值  

Prenatal echocardiographic diagnosis of right aortic arch and its branch type

作　　者：刘伟伟[1] 王岳恒[1] 王菊 Liu Weiwei;Wang Yueheng;Wang Ju(Department of Cardiac Ultrasound,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院心脏超声科,石家庄050000

出　　处：《中华超声影像学杂志》2018年第8期674-677,共4页Chinese Journal of Ultrasonography

基　　金：河北省应用基础研究计划重点基础研究项目（16967796D）

摘　　要：目的探讨产前超声心动图在快速诊断右位主动脉弓及其分型中的应用价值，提供快速诊断方法。方法回顾性分析55例产前诊断为右位主动脉弓的胎儿超声心动图图像，总结其声像图特征。结果产前诊断55例右位主动脉弓胎儿中，右位主动脉弓并迷走左锁骨下动脉（RAA—ALSA）42例，右位主动脉弓并镜像分支（RAA—MB）13例，其中1例双主动脉弓误诊为RAA—MB。RAA—ALSA产前诊断要点：三血管-主动脉弓切面第一个分支为左颈总动脉走行于气管前方，迷走左锁骨下动脉在气管和食管后方向左走行。RAA—MB表现为主动脉弓第一个分支为左头臂动脉，在气管前方跨过气管向左走行、较粗，发出左颈总动脉和锁骨下动脉。结论产前超声根据主动脉弓的第一个分支方向、粗细、有无二级分支能够快速准确诊断右位主动脉弓及其分支类型，明确动脉导管位置有助于判定血管环的形成。Objective To investigate the value of prenatal ecbocardiographic diagnosis of anomalies of the right aortic arch（RAA） and its branch type, and provide rapid diagnostic methods. Methods A retrospective analysis of 55 cases of RAA of prenatal ultrasound diagnosis results, and their imaging characteristics were summarized. Results There were 55 cases of anomalies of the RAA,included 42 cases of RAA with aberrant left subclavian artery（RAA-ALSA） and 13 cases of RAA with mirror image branching pattern（RAA-MB）, 1 case of double aortic arch（DAA） was misdiagnosed as RAA. The prenatal echocardiographic characteristics of RAA-ALSA： in three-vessel-aortic arch view, the first branch of the aortic arch was the left carotid artery, which ran in front of the trachea, and ALSA ran behind the trachea and esophagus. The prenatal echocardiographic characteristics of RAA MB： the first branch of the aortic arch was the brachiocephalic trunk, which ran in front of the trachea and was divided to the left carotid artery and the left subclavian artery. Conclusions Prenatal ultrasound can qunickly and accurately diagnose anomalies of the right aortic arch and its branch type according to the direction, thickness and secondary branches of the first branch of the aortic arch. The location of arterial duct is helpful to judge the formation of vascular ring.

关 键 词：超声检查 产前 右位主动脉弓 血管环 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]