超声在小儿永存第5主动脉弓诊断评估中的临床价值  

Clinical Value of Ultrasound in Diagnosis and Evaluation of Persistent Fifth Aortic Arch in Children

作　　者：贺新建[1] 魏九茹[2] 崔云 陈娇阳 张帅 陶曙光[3] 赵宁[1] 任哲 He Xinjian;Wei Jiuru;Cui Yun;Chen Jiaoyang;Zhang Shuai;Tao Shuguang;Zhao Ning;Ren Zhe(Department of Ultrasound Diagnosis,Hebei Children's Hospital,Pediatric Cardiovascular Key Laboratory of Hebei Province,Hebei Clinical Medical Research Center of the Children's Health and Disease,Shijiazhuang 050031,China;Fetal Health Department of Hebei Maternal and Child Health Center,Shijiazhuang 050031,China;Department of Cardiac Surgery,Hebei Children's Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院超声诊断科,河北省小儿心血管重点实验室,河北省儿童健康与疾病临床医学研究中心,石家庄市050031 [2]河北省妇幼保健中心胎儿保健科,石家庄市050031 [3]河北省儿童医院心脏外科,石家庄市050031

出　　处：《中国超声医学杂志》2024年第3期336-339,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨超声在小儿永存第5主动脉弓(PFAA)诊断评估中的临床指导价值。方法 收集超声诊断且经电子计算机断层扫描血管造影(CTA)或手术证实的11例PFAA患儿资料,分析不同分型的超声特征并进行评估。结果 11例超声诊断与CTA或手术结果均相符。2例右位PFAA合并血管环或法洛四联证,9例左位PFAA均未合并复杂畸形。Weinberg A型4例:1例右位双腔主动脉弓(无血流梗阻)合并法洛四联证及迷走左锁骨下动脉,行法洛四联证根治术;2例左位双腔主动脉弓无梗阻者未手术;1例左位双腔主动脉弓PFAA远端闭锁伴主动脉缩窄,行主动脉缩窄纠治术。B型7例:第4主动脉弓离断伴PFAA缩窄6例,其中4例重度缩窄左心室收缩功能减低者行急诊手术;1例发现后早期行PAFF缩窄纠治术;1例放弃治疗;1例不伴缩窄者只行房间隔缺损修补术。补充1例C型胎儿病例,追踪失访。结论 重度缩窄导致左心收缩功能减低是小儿PFAA最常见的危害之一,需急诊手术,右位PFAA易合并血管环及其他复杂畸形。超声在PFAA的诊断评估中具有重要价值。Objective To investigate the clinical value of ultrasound in diagnosis and evaluation of persistent fifth aortic arch(PFAA) in children.Methods A total of 11 children with PFAA diagnosed by ultrasound and confirmed by computed tomography angiography(CTA) or surgery in our hospital were collected.The ultrasonic characteristics of different types were analyzed.Results The ultrasonographic diagnoses of 11 cases were consistent with CTA or surgical results.There were 2 cases of right PFAA with vascular ring or tetralogy of Fallot(TOF),and 9 cases of left PFAA without complicated malformation.There were 4 cases of Weinberg Type A:1 case of right double-lumen aortic arch(without blood flow obstruction) combined with TOF and aberrant left subclavian artery underwent radical operation of TOF;2 cases of left double-lumen aortic arch without blood flow obstruction were not treated surgically;A case of left double-lumen aortic arch with PFAA distal atresia and aortic coarctation underwent aortic coarctation correction surgery.There were 7 cases of Type B:6 cases were with interruption of aortic arch and coarctation of PFAA,of which 4 with severe coarctation and reduced left ventricular systolic function received emergency surgery;1 case underwent PFAA coarctation correction surgery early after discovery;1 case gave up treatment;1 case without coarctation only underwent repair of atrial septal defect.One fetal case of type C was added,but follow-up was lost.Conclusions Reduced left ventricular systolic function caused by severe coarctation is one of the most common serious risks in pediatric patients with PFAA,which needs urgent surgical intervention.The right PFAA is prone to vascular rings and other complex malformations.Ultrasound has important clinical guiding value in diagnosis and evaluation ofPFAA.

关 键 词：先天性心脏病 永存第5主动脉弓 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.4[医药卫生—诊断学]