CAJ | 학술논문

目的：探讨双主动脉弓胎儿产前超声心动图特征及产前诊断临床意义。方法对南京医科大学附属苏州医院2012年1月至2013年2月产前超声心动图检出的5例双主动脉弓胎儿的超声心动图特征、分型及临床结局进行总结分析。结果5例双主动脉弓胎儿超声心动图表现：（1）三血管气管观中主动脉与动脉导管失去正常“V”字形结构，升主动脉发出左、右主动脉弓围绕气管，彩色多普勒血流成像示环状血流信号围绕气管。（2）超声心动图示5例胎儿中3例为右主动脉弓优势型，2例为左、右主动脉弓平衡型。（3）1例（例2）胎儿合并膜部室间隔缺损、永存左上腔静脉；1例（例4）胎儿合并半椎体畸形，3例胎儿未发现合并其他畸形。5例胎儿均行磁共振检查并随访至引产或产后3个月，随访检查均证实胎儿为双主动脉弓畸形。结论双主动脉弓是胎儿严重的先天性心脏病，超声心动图是产前首选的诊断方法，三血管气管观是诊断双主动脉弓的有效切面。
목적：탐토쌍주동맥궁태인산전초성심동도특정급산전진단림상의의。방법대남경의과대학부속소주의원2012년1월지2013년2월산전초성심동도검출적5례쌍주동맥궁태인적초성심동도특정、분형급림상결국진행총결분석。결과5례쌍주동맥궁태인초성심동도표현：（1）삼혈관기관관중주동맥여동맥도관실거정상“V”자형결구，승주동맥발출좌、우주동맥궁위요기관，채색다보륵혈류성상시배상혈류신호위요기관。（2）초성심동도시5례태인중3례위우주동맥궁우세형，2례위좌、우주동맥궁평형형。（3）1례（례2）태인합병막부실간격결손、영존좌상강정맥；1례（례4）태인합병반추체기형，3례태인미발현합병기타기형。5례태인균행자공진검사병수방지인산혹산후3개월，수방검사균증실태인위쌍주동맥궁기형。결론쌍주동맥궁시태인엄중적선천성심장병，초성심동도시산전수선적진단방법，삼혈관기관관시진단쌍주동맥궁적유효절면。
Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of fetal double aortic arch (DAA). Methods Totally 21 596 fetuses underwent fetal echocardiography in Nanjing Medical University Afifliated Suzhou Hospital and ifve cases were diagnosed as DAA by echocardiography. Echocardiographic characteristics, types and outcomes of these ifve cases were summarized retrospectively. Results Five fetal cases were diagnosed as DAA by fetal echocardiography. 1. Prenatal echocardiographic features:In three-vessel and trachea view, the normal“V”-shaped conlfuence formed by the aortic arch and ductal arch was absent. However, the ascending aorta bifurcated into the left and right aortic arch and these two arches encircled the trachea. Annular lfow signal around trachea was seen on color Doppler imaging. 2. Types:Among these ifve fetuses, three cases were called right arch predominant type, whose diameters of right arches were larger than those of left arches. The other two were balanced type, whose diameters of right arches were almost equal to those of left arches. 3. Accompanied malformations:Case 2 was accompanied with membranous ventricular septal defect and permanent left superior vena cava. Case 4 was associated by hemivertebrae. The other three cases had no other abnormalities. 4. Follow-up:These five cases were all arranged for MRI subsequently and all were confirmed by follow-up till to the induction of labor or three months after birth. Conclusions Double aortic arch is a kind of severe congenital heart disease. Echocardiography is the ifrst choice to diagnose DAA prenatally and three-vessel and trachea view are the effective cross sections in the diagnosis of double aortic arch.