Diagnostic value of three sections of aortic arch under ultrasonography in fetal aortic coarctation

Q4 Medicine

中华围产医学杂志 Pub Date : 2019-09-16 DOI:10.3760/CMA.J.ISSN.1007-9408.2019.09.013

Juan Wu, Yun Liu, Ming Wang, Xinxia Wang, Shan Lin, R. Yuan, Hezhou Li, S. Cui

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Abstract

Objective To investigate the diagnostic value of three sections of aortic arch under ultrasonography, including the three vessels and tracheal view (3VT), long-axis and coronal view of the aortic arch, in fetal coarctation of the aorta (CoA) and the reasons for missed diagnosis and misdiagnosis. Methods This study involved 52 fetuses with CoA who were identified by prenatal ultrasonography and confirmed in postnatal operation in the Third Affiliated Hospital of Zhengzhou University from June 2013 to June 2018. Echocardiographic findings of all cases were analyzed retrospectively to summarize the prenatal imaging features. Results The 3VT was displayed in all cases (100%). The long-axis view of the aortic arch was observed in 88.5%, while the coronal view was observed in 76.9%. Among the 52 cases, nine were missed diagnosis and three were misdiagnosed due to unsatisfactory views of the three sections of aortic arch. All cases showed an increased ratio of the pulmonary artery to the aorta diameter in 3VT, which was a critical indicator of CoA in prenatal ultrasonographic diagnosis. Satisfactory aortic arch coronal views were obtained in 40 cases and all showed constriction at the isthmus of aortic arch and an connection to the descending aorta. Out of the 46 with a satisfactory long-axis view of the aortic arch, a narrow isthmus of aortic arch was shown in 38 cases, with the inner diameter of (1.8±0.2) mm ranging from 0.9 to 2.9 mm. Conclusions Observation of three sections of aortic arch under ultrasonography is of great importance in prenatal diagnosis of CoA. Key words: Aortic coarctation; Aorta, thoracic; Ultrasonography, prenatal; Fetal heart

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超声检查三段主动脉弓对胎儿主动脉缩窄的诊断价值

目的探讨主动脉弓三血管及气管位(3VT)、主动脉弓长轴及冠状位(长轴及冠状位)超声对胎儿主动脉缩窄(CoA)的诊断价值及漏诊、误诊的原因。方法选取2013年6月至2018年6月郑州大学附属第三医院经产前超声诊断并经产后手术确诊的52例CoA胎儿为研究对象。回顾性分析所有病例的超声心动图表现，总结产前影像学特征。结果所有病例均显示3VT(100%)。主动脉弓长轴位占88.5%，冠状位占76.9%。52例中，9例漏诊，3例因主动脉弓3段影像不理想而误诊。所有病例均在3VT时肺动脉与主动脉直径之比增加，这是产前超声诊断CoA的重要指标。40例均获得满意的主动脉弓冠状位，均显示主动脉弓峡部狭窄，并与降主动脉相连。46例主动脉弓长轴影像满意的病例中，38例主动脉弓峡部狭窄，内径(1.8±0.2)mm，范围0.9 ~ 2.9 mm。结论超声检查三段主动脉弓对产前诊断CoA有重要意义。关键词:主动脉缩窄;胸主动脉;产前超声;胎儿心脏

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来源期刊

中华围产医学杂志 Medicine-Obstetrics and Gynecology

CiteScore

0.70

自引率

0.00%

发文量

4446

期刊介绍： Chinese Journal of Perinatal Medicine was founded in May 1998. It is one of the journals of the Chinese Medical Association, which is supervised by the China Association for Science and Technology, sponsored by the Chinese Medical Association, and hosted by Peking University First Hospital. Perinatal medicine is a new discipline jointly studied by obstetrics and neonatology. The purpose of this journal is to "prenatal and postnatal care, improve the quality of the newborn population, and ensure the safety and health of mothers and infants". It reflects the new theories, new technologies, and new progress in perinatal medicine in related disciplines such as basic, clinical and preventive medicine, genetics, and sociology. It aims to provide a window and platform for academic exchanges, information transmission, and understanding of the development trends of domestic and foreign perinatal medicine for the majority of perinatal medicine workers in my country.