胎儿主动脉缩窄产前超声误诊分析

发布时间：2018-11-06 20:39

【摘要】：目的探讨胎儿主动脉缩窄误诊的原因,为胎儿主动脉缩窄的产前超声诊断提供帮助。方法回顾性分析67例产前超声疑诊主动脉缩窄胎儿,其中出生后证实为阴性的19例胎儿、证实为主动脉弓离断的2例胎儿的产前超声声像图特征及合并心内外畸形情况。结果主动脉缩窄的误诊率为31.3%,19例阴性胎儿均表现为右心室横径/左心室横径1.3、肺动脉明显大于主动脉、主动脉峡部内径小于0.3 cm,其中8例合并主动脉弓形态失常,11例出现了主动脉弓反向血流;4例肺动脉/主动脉1.6,15例肺动脉/主动脉在1.45~1.58之间。2例主动脉弓离断胎儿除了未探及明显主动脉弓反向血流,以上征象均具备。19例阴性胎儿中8例合并心内畸形、6例合并心外畸形;2例主动脉弓离断胎儿未合并心内外畸形。结论胎儿主动脉缩窄的产前超声诊断存在较高的误诊率,胎儿期诊断主动脉缩窄要非常慎重,与心室不对称、右心增大相比,肺动脉/主动脉1.6、主动脉峡部绝对值及相对值对诊断主动脉缩窄特异性更高。
[Abstract]:Objective to investigate the causes of misdiagnosis of fetal aortic coarctation and to provide help for prenatal ultrasound diagnosis of fetal aortic coarctation. Methods Sixty-seven fetuses with suspected constriction of aorta were analyzed retrospectively, 19 of them were confirmed to be negative after birth, 2 of them were confirmed as having broken aortic arch. Results the misdiagnosis rate of aortic coarctation in 19 cases of negative fetuses was right ventricular transverse diameter / left ventricular transverse diameter 1.3, pulmonary artery was obviously larger than aorta, aortic isthmus diameter was less than 0.3 cm,. Among them, 8 cases were complicated with abnormal shape of aortic arch, 11 cases had reverse flow of aortic arch. 15 cases of pulmonary artery / aorta were between 1.45 and 1.58. The reverse flow of aortic arch was not detected in 2 cases except that there was no obvious reverse flow of aortic arch in 2 cases. Among the 19 cases of negative fetus, 8 cases were complicated with intracardiac malformation and 6 cases were complicated with extracardiac malformation. 2 fetuses with aortic arch dissection were not complicated with intraventricular and extraventricular malformations. Conclusion there is a high misdiagnosis rate in prenatal ultrasound diagnosis of fetal aortic coarctation. The diagnosis of aortic coarctation in fetal phase should be very careful. Compared with ventricular asymmetry and right heart enlargement, pulmonary artery / aorta 1.6. The absolute and relative values of aortic isthmus are more specific for the diagnosis of aortic coarctation.
【作者单位】：广东省妇幼保健院超声科;广东省妇幼保健院病理科;
【分类号】：R445.1;R714.5

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