胎儿左头臂静脉正常与异常超声图像特征及其临床意义  

Ultrasonographic features of normal and abnormal fetal left brachiocephalic vein and their clinical significance

作　　者：黄佳[1] 石华[1] 张玉国[1] 胡佳琪[1] 陈茜[1] Jia Huang;Hua Shi;Yuguo Zhang;Jiaqi Hu;Qian Chen(Ultrasonography Center of Obstetrics and Gynecology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院妇产超声科,430060

出　　处：《中华医学超声杂志（电子版）》2023年第6期610-617,共8页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨产前超声观察胎儿正常与不同类型异常左头臂静脉的图像特征及临床意义。方法收集2018年1月至2021年11月在武汉大学人民医院接受胎儿心脏超声检查并诊断为左头臂静脉异常的胎儿43例,回顾性分析43例胎儿左头臂静脉异常产前超声图像特征及胎儿伴发异常情况,随访染色体检查结果及妊娠结局。另选取正常胎儿248例,测量左头臂静脉内径,分析其与孕龄的相关性。结果43例胎儿左头臂静脉异常包括以下3种类型:左头臂静脉走行异常,其中主动脉弓下走行25例,胸腺内走行6例,食管后走行2例。左头臂静脉缺如7例。左头臂静脉内径异常,其中内径明显增宽2例,内径细小1例。其中19例伴发其他异常,包括右位主动脉弓、法洛四联症、大动脉转位、永存左上腔静脉、完全性心上型肺静脉异位引流等。正常18~34周胎儿左头臂静脉内径范围为(1.9~3.98 mm),与孕龄呈线性正相关关系,回归方程为左头臂静脉内径(mm)=-0.6796+0.1352孕龄。结论产前超声可观察胎儿左头臂静脉的位置、走行及形态,正常左头臂静脉内径随孕龄呈线性增长。加强左头臂静脉各类型异常超声图像特征及临床意义的认识,可为临床咨询提供信息和依据。Objective To investigate the ultrasound characteristics and clinical significance of different types of left brachiocephalic vein(LBCV)abnormalities in fetuses.Methods Forty-three cases of LBCV abnormalities diagnosed at Wuhan University People's Hospital from January 2018 to November 2021 were included,and fetal complications,chromosome examination,and clinical follow-up outcomes were retrospectively summarized.The ultrasonographic features and clinical significance of different types of LBCV abnormalities were then analyzed and summarized.In addition,248 normal fetuses were examined.The inner diameter of the normal LBCV was measured and its correlation with gestational age was analyzed.Results The 43 cases of LBCV abnormalities included the following three types:Abnormal course of the LBCV(traveling under the aortic arch in 25 fetuses,penetrating the thymus in 6,and retroesophageal or retrotracheal LBCV in 2);absent LBCV in 7 fetuses;and abnormal diameter of the LBCV(significantly widened inner diameter in 2 fetuses,and smaller inner diameter in 1).Nineteen were detected with other malformations,including right aortic arch,tetralogy of Fallot,transposition of the great arteries,persistent left superior vena cava,and total anomalous pulmonary vein communication.The mean inner diameter of the LBCV in normal fetuses at 18 to 34 weeks ranged from 1.9 mm to 3.98 mm,which showed a positive linear correlation with gestational age.The regression equation was:LBCV inner diameter(mm)=-0.6796+0.1352×gestational age(GA).Conclusion The position,course,and morphology of the LBCV can be observed by prenatal ultrasound.The inner diameter of the normal LBCV increases linearly with gestational age.Knowing the ultrasonographic features and clinical significance of different types of LBCV abnormalities can provide information and evidence for clinical consultation.

关 键 词：胎儿 超声检查 产前 左头臂静脉 

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]