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目的:观察胎儿主动脉弓部连接异常的产前超声诊断情况,分析产前超声诊断的临床应用价值。方法:选取2013年1月-2014年12月在本院产前超声诊断为胎儿主动脉缩窄和胎儿主动脉弓离断的孕妇92例作为研究对象。先对所有孕妇行产前超声检查,然后进行引产后心脏解剖、磁共振成像、新生儿心脏检查以及外院随访等方式确诊,分析产前超声诊断的临床应用价值。结果:92例孕妇产前超声心电图诊断为主动脉缩窄68例,主动脉弓离断24例。经过引产后心脏解剖确诊52例,其中主动脉缩窄40例,主动脉弓离断12例;磁共振成像确诊28例,其中主动脉缩窄20例,主动脉弓离断8例;新生儿心脏检查确诊6例,均为主动脉缩窄;外院随访确诊6例,其中2例为主动脉狭窄,4例为主动脉弓离断。误诊6例,4例为主动脉缩窄误诊为主动脉弓离断,2例主动脉弓离断误诊为主动脉缩窄。超声心电图5个常用切面显示,主动脉弓长轴观、动脉导管弓观以及三血管气管观的诊断率较高。结论:主动脉弓长轴观是诊断主动脉缩窄的最佳切面,产前超声诊断可为临床最终诊断胎儿主动脉缩窄和主动脉弓离断提供可靠依据。
OBJECTIVE: To observe the prenatal diagnosis of anomalous fetal arch connections and analyze the clinical value of prenatal diagnosis. Methods: Ninety-two pregnant women who were diagnosed as fetus aortic constriction and aortic arch disconnection by prenatal ultrasound in our hospital from January 2013 to December 2014 were selected as the research object. Prenatal ultrasound examination of all pregnant women first, and then post-induction of cardiac anatomy, magnetic resonance imaging, neonatal cardiac examination and follow-up of other hospitals confirmed the diagnosis of prenatal ultrasound clinical value. Results: Prenatal echocardiography in 92 pregnant women was diagnosed as aortic stenosis in 68 cases and aortic arch in 24 cases. After the induction of cardiac anatomy of 52 cases, of which 40 cases of aortic stenosis, aortic arch off in 12 cases; magnetic resonance imaging diagnosis of 28 cases, including aortic stenosis in 20 cases, aortic arch off in 8 cases; neonatal cardiac examination confirmed 6 Cases, are aortic constriction; external hospital follow-up diagnosis of 6 cases, of which 2 cases of aortic stenosis, 4 cases of aortic arch off. 6 cases were misdiagnosed, 4 cases were misdiagnosed as aortic arch segmental aortic arch, and 2 cases were diagnosed as aortic constriction by aortic arch segmental misdiagnosis. Echocardiography 5 commonly used section shows aortic arch view of the long axis of the ductus arteriosus and the three vascular trachea view of the diagnosis rate. CONCLUSION: The long axis view of the aortic arch is the best section for diagnosis of aortic constriction. Prenatal ultrasound diagnosis can provide a reliable basis for the final diagnosis of aortic arch stenosis and aortic arch disconnection.