胎儿主动脉弓异常超声诊断方法研究.docVIP

胎儿主动脉弓异常超声诊断方法研究 　　[摘要] 目的 研究胎儿主动脉弓异常的产前超声声像图，探讨胎儿主动脉弓异常的畸形特征。 方法 以2014年1月～2016年3月我院行产前系统超声检查诊断为主动脉弓异常的胎儿55例作为研究对象进行回顾性分析，分析其产前超声图像特征及结局。 结果 （1）55例先天性主动脉弓异常胎儿中，右位主动脉弓及主动脉弓分支异常27例，主动脉弓缩窄19例，主动脉弓离断7例，双主动脉弓2例，结果获得验证的病例为47例，准确率为85.40%，其中13例合并其他严重心脏畸形，6例染色体异常，14例合并心外畸形。（2）主动脉弓缩窄及主动脉弓离断的超声声像线索为三血管-气管切面、主动脉弓长纵轴切面及经气管冠状切面均显示主动脉弓内径异常小，与动脉导管内径比例失调；右位主动脉弓及其分支异常线索为主动脉弓位于气管右侧、与动脉导管之间距离增大呈“U”形，和（或）在气管后方有发自降主动脉起始段的血管分支。 结论 先天性主动脉弓异常的各个类型均有特征性的超声声像，其最有效的扫查切面是三血管切面和三血管气管切面，产前超声诊断准确率较高，主动脉弓异常可能合并其他严重心内外畸形及染色体异常，预后不良。 　　[关键词] 胎儿；主动脉弓；超声；产前诊断 　　[中图分类号] R714.5 [文献标识码] A [文章编号] 2095-0616（2017）05-111-03 　　[Abstract] Objective To explore the prenatal ultrasonographic diagnosis of fetal aortic arch anomalies， and to explore abnormal features of fetal aortic arch anomalies. Methods 55 cases of fetus with aortic arch anomaly diagnosed by prenatal systematic ultrasonography in our hospital from January 2014 to March 2016 were selected as the study objects， and they were retrospectively analyzed. Characteristics and outcome of prenatal ultrasound images were analyzed. Results （1） In the 55 cases of congenital aortic arch anomalies， the right aortic arch and aortic arch branch were abnormal in 27 cases， coarctation of the aortic arch were 19 cases， aortic arch interruption were 7 cases， and double aortic arch were 2 cases. As a result， 47 cases were confirmed， the accuracy rate was 85.40%. Among them， 13 cases were complicated with other severe cardiac malformations， including chromosome abnormality in the other 6 cases， and in the other 14 cases. （2） Ultrasonographic clues of coarctation of the aorta and aortic arch was three vessels and trachea view， aortic arch long axis section and transtracheal coronal section showed aortic arch anomalies of small diameter and proportional to the diameter of the ductus arteriosus. The right aortic arch and its branches were the “U” shape of the aortic arch located on the right side of the trachea， and the distance between the aortic arch and the ductus