三血管气管切面联合弓降部冠状切面对主动脉弓及分支畸形的产前诊断应用价值  

The fetal three-vessel and tracheal view and descending aortic arch coronary view in the prenatal diagnosis for anomalies of arch branches

作　　者：阳立文 周柳英 陈琳 陈桦 杨泽萱 YANG Li-wen;ZHOU Liu-ying;CHEN Ling;CHEN Hua;YANG Ze-xuan(Department of Ultrasound,Chengdu Women and Children's Central Hospital,Chengdu 610091,China)

机构地区：[1]成都市妇女儿童中心医院超声科,四川成都610091

出　　处：《实用医院临床杂志》2018年第1期72-75,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨三血管气管切面联合弓降部冠状切面对诊断主动脉弓及分支畸形的产前超声价值。方法回顾性分析50例主动脉弓异常胎儿的超声心动图特征,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在三血管气管切面及弓降部冠状切面的超声表现。结果所有病例在三血管气管切面及弓降部冠状切面上均有特异性超声表现。其中主动脉弓缩窄8例,有6例表现为不对称的"V"形及"Y"形,2例表现为"V"形及"Y"形结构消失;主动脉弓离断11例,表现为"V"形及"Y"形结构消失;右位主动脉弓伴左锁骨下动脉迷走和左位动脉导管8例,表现为主动脉弓位于气管右侧,包绕气管的"U"形血管环,以及发自降主动脉的迷走左锁骨下动脉;左位主动脉弓伴右锁骨下动脉迷走和左位动脉导管6例,表现为主动脉弓位于气管左侧,包绕气管的"C"形血管环,以及发自降主动脉的迷走右锁骨下动脉;镜面右位主动脉弓12例;表现为主动脉弓位于气管右侧,主动脉弓发出的第一分支均为左无名动脉;双主动脉弓5例,表现为包绕气管的"O"形血管环以及位于降主动脉两侧的左右双弓。结论三血管气管切面是诊断胎儿主动脉弓及分支畸形的有效切面;弓降部冠状切面是鉴别诊断主动脉弓异常类型的重要辅助切面。To explore the prenatal diagnostic value of the three-vessel and tracheal view(3VT)and descending aortic arch coronary view for aortic arch abnormalities.Echocardiographic characteristics of 50 fetuses with aortic arch abnormalities were retrospectively analyzed and compared with pathology and postnatal echocardiography.The ultrasound features of different types of aortic arch abnormalities in 3VT view and descending arotic arch coronary view were analyzed.In all cases,the 3VT view and descending aortic arch coronary view were abnormal.Of these,8 cases were aortic coarctation,in which 6 cases were mainly manifested as asymmetric V-and Y-shaped,and 2 cases manifested as V-shaped and disappearance of Y-shaped structures.There were 11 cases with interrupted aortic arch manifested as disappearance of V-shaped and Y-shaped structures.Eight cases were right aortic arch with aberrant left subelavian artery and left ductus arteriosus manifested as the aortic arch situating to the right of the trachea with a U-shaped vascular loop around the trachea.Six cases were left aortic arch with aberrant right subelavian artery and left ductus arteriosus manifested as the aortic arch situating to the left of the trachea with a C-shaped vascular loop around the trachea and the aberrant right subelavian artery originated from descending aorta.Twelve cases were right arotic arch manifested as mirror-image branching with the aortic arch in the right side of the trachea,and the first branch of the aortic arch was the left innominate artery.Five cases were double aortic arch manifested as an O-shaped vascular loop around the trachea,and left aortic arch and right aortic arch were situated to double sides of descending aorta.The 3VT view is very effective for diagnosing aortic arch and branches anomalies.Descending aortic arch coronary view is supplemental view to differential diagnosis of the type of arotic arch and branches anomalies.

关 键 词：胎儿 超声检查 三血管气管 弓降部冠状切面 主动脉弓畸形 

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]