超声心动图诊断胎儿右位主动脉弓及预后评估

发布时间：2018-04-11 03:36

本文选题：胎儿 + 右位主动脉弓　；参考：《中国医学影像技术》2016年04期

【摘要】：目的探讨超声心动图诊断胎儿右位主动脉弓(RAA)及其在预后评估中的应用价值。方法回顾性分析经超声心动图诊断为胎儿RAA的25名单胎孕妇资料。7胎引产终止妊娠,对其中4胎进行胎儿尸体检查。对18胎继续妊娠者,于产后1个月内对患儿行超声心动图、MR或CT检查,并临床随访半年,观察患儿有无反复发作的气管或食管受压症状。结果 19胎为RAA伴左位动脉导管、迷走左锁骨下动脉,4胎为RAA伴头臂动脉镜像分支(3胎伴右位动脉导管、1胎伴左位动脉导管),2胎为双主动脉弓。18胎为单纯性RAA,余7胎合并其他心内外畸形,且包括2胎染色体异常。4胎经尸体检查证实为RAA。18胎出生后经超声心动图、MR或CT检查证实为RAA患儿,且出生后半年内15例患儿无明显气管或食管受压症状,3例出现反复发作的慢性咳嗽、气喘,吞咽困难,经抗感染治疗后症状缓解。结论超声心动图是诊断胎儿RAA的可靠方法;胎儿RAA的预后主要与是否并发其他心内外畸形或染色体异常有关。
[Abstract]:Objective to evaluate the value of echocardiography in the diagnosis of fetal right aortic arch (RAA) and its prognostic evaluation.Methods the data of 25 pregnant women with fetal RAA diagnosed by echocardiography were analyzed retrospectively. Pregnancy induced pregnancy was terminated. Fetal cadavers were examined in 4 of 25 fetuses.Echocardiographic Mr or CT examination was performed on 18 children who continued pregnancy within 1 month after delivery. The children were followed up for half a year to see if they had recurrent symptoms of trachea or esophageal compression.Results 19 fetuses were RAA with left artery catheter.4 cases of left subclavian artery with RAA, 3 cases with right artery ductus arteriosus, 1 fetus with left artery ductus arteriosus, 2 cases with double aortic arch. 18 fetus are simple RAA, the remaining 7 cases are complicated with other internal and external cardiac malformations.In addition, 2 cases with chromosomal abnormalities were confirmed by cadaveric examination to be children with RAA after birth by echocardiography, Mr or CT, and were confirmed by cadaveric examination.There were no obvious symptoms of trachea or esophagus compression in 15 children within six months after birth. 3 cases had recurrent chronic cough, asthma and dysphagia, and the symptoms were relieved after anti-infection treatment.Conclusion Echocardiography is a reliable method for the diagnosis of fetal RAA, and the prognosis of fetal RAA is mainly related to other anomalies of heart and heart or chromosomal abnormalities.
【作者单位】：成都市西区医院产科;重庆市妇幼保健院超声科;
【基金】：重庆市卫生局面上项目(2010-2-327)
【分类号】：R540.45;R714.5

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