孤立性左锁骨下动脉和左侧头臂干畸形的超声诊断与预后分析  

Ultrasonic Diagnosis and Prognosis of Isolated Left Subclavian Artery and Left Brachiocephalic Trunk Malformation

作　　者：闫亚妮[1] 杨振娟[1] 李云桃[1] 薛小伟 张晓红[1] 裴秋艳[1] Yan Yani;Yang Zhenjuan;Li Yuntao;Xue Xiaowei;Zhang Xiaohong;Pei Qiuyan(Department of Obstetric,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院产科,北京市100044

出　　处：《中国超声医学杂志》2021年第9期1024-1027,共4页Chinese Journal of Ultrasound in Medicine

基　　金：首都卫生发展科研专项项目(No.首发2018-2-4083);北京市卫生与健康科技成果和适宜技术推广项目(No.2018-TG-78)。

摘　　要：目的分析孤立性左锁骨下动脉和孤立性左侧头臂干畸形的产前超声特征、临床表现及预后。方法对产前诊断的胎儿及pubmed所检索到的婴幼儿和成人ILSCA和ILBCT的超声特征、临床表现及预后进行分析。结果孤立性左锁骨下动脉和孤立性左侧头臂干畸形的超声特征为左锁骨下动脉或左头臂干不与主动脉弓相连,多为右位主动脉弓合并右位动脉导管。66例患者中孤立性左侧头臂干10例,孤立性左锁骨下动脉56例,其中4例胎儿引产,剩余62例中,40例有临床表现描述资料,分别为左上肢异常(无力、桡动脉搏动减弱、血氧饱和度减低、发育不良)36例,神经系统异常4例。23例产后进行了锁骨下动脉或头臂干移植手术,术后无并发症。结论对右位主动脉弓合并右位动脉导管的胎儿,仔细追踪左锁骨下动脉和左颈总动脉起源,结合血流频谱特征,可以提高ILSCA和ILBCT产前诊断率。Objective The purpose of the study was to analyse ultrasonographic features,clinical manifestations and prognosis of isolated left subclavian artery(ILSCA)and isolated left brachiocephalic trunk(ILBCT)malformations.Methods Fetuses prenatally diagnosed ILSCA and ILBCT in our hospital,Infants and adults diagnosed of ILSCA and ILBCT in Pubmed.The ultrasonic features,clinical manifestations and prognosis were analyzed.Results The ultrasonic features of ILSCA and ILBCT were that the left subclavian artery or left brachiocephalic trunk didn′t connect with the aortic arch.Most of them were right aortic arch associated with the right ductus arteriosus.Among the 66 cases,10 cases were ILBCT,56 cases of ILSCA.Among them,4 cases were induced labor,and 40 of the remaining 62 cases had clinical description.There were 36 cases of left upper limb abnormality(weakness,radial artery pulsation weakening,oxygen saturation decreasing,dysplasia)and 4 cases of nervous system abnormality,Twenty three patients underwent subclavian artery transplantation or brachiocephalic trunk transplantation and no complications occurred.Conclusions For fetuses diagnosed as RAA with RDA,Finding out the origin of the left subclavian artery and left common carotid artery and combining the blood flow spectrum characteristics can improve the rate of prenatal diagnosis of ILSCA and ILBCT.

关 键 词：孤立性左锁骨下动脉 孤立性左侧头臂干 胎儿超声心动图 超声特征 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.53[医药卫生—诊断学]