CAJ | 학술논문

目的对比分析超声与磁共振对血管环的产前诊断、染色体筛查及出生后随访结果,探讨产前诊断技术对血管环诊断与预后评估的临床价值.方法对95例孕期经胎儿超声心动图检查诊断为血管环的胎儿定期随访,其中染色体筛查72例,磁共振检查31例,并与出生后随访结果进行对比分析.结果 95例血管环中右位主动脉弓、左位动脉导管型85例,肺动脉吊带和双主动脉弓型各4例,右位主动脉弓、双动脉导管和左位主动脉弓伴迷走右锁骨下动脉型各1例.本组中单纯性血管环66例,复合性29例(合并其他心血管畸形).出生54例(2例夭折),待出生8例,失访6例,引产27例.产前超声及磁共振检查提示气管受压6例,出生5例中仅有3例出现气管受压的临床症状.结论胎儿血管环以单纯性最多见,产前超声可以明确诊断血管环并进行分型,孕期超声动态随访并结合磁共振检查有利于判断与评估血管环对气管的压迫程度及预后.
목적 대비분석초성여자공진대혈관배적산전진단、염색체사사급출생후수방결과,탐토산전진단기술대혈관배진단여예후평고적림상개치.방법 대95례잉기경태인초성심동도검사진단위혈관배적태인정기수방,기중염색체사사72례,자공진검사31례,병여출생후수방결과진행대비분석.결과 95례혈관배중우위주동맥궁、좌위동맥도관형85례,폐동맥조대화쌍주동맥궁형각4례,우위주동맥궁、쌍동맥도관화좌위주동맥궁반미주우쇄골하동맥형각1례.본조중단순성혈관배66례,복합성29례(합병기타심혈관기형).출생54례(2례요절),대출생8례,실방6례,인산27례.산전초성급자공진검사제시기관수압6례,출생5례중부유3례출현기관수압적림상증상.결론 태인혈관배이단순성최다견,산전초성가이명학진단혈관배병진행분형,잉기초성동태수방병결합자공진검사유리우판단여평고혈관배대기관적압박정도급예후.
Objective By comparing the results of prenatal diagnosis of vascular rings by ultrasound and MRI,chromosome screening and postnatal follow ups,to explore the clinical significance of prenatal diagnostic technology for the diagnosis of vascular rings and prognostic assessment.Methods Ninety-five fetuses that were diagnosed by fetal echocardiography were followed up regularly,of which 72 cases had chromosome screening,31 cases had MRI examination.These results were compared with the postnatal follow-up outcome.Results Ninety-five cases of vascular rings included 85 cases of right aortic arch(RAA) and left ductus arteriosus(LDA),4 cases of pulmonary artery sling(LPAS),4 cases of double aortic arch (DAA),1 case of RAA and double ductus arteriosus(DDA),1 case of left aortic arch(LAA) and aberrant right subclavian artery(ARSA).Sixty-six cases of isolated vascular rings and 29 cases of complex vascular rings(combined with other cardiovascular abnormalities) were detecded.Fifty-four cases were born (2 infants died),8 cases were ongoing pregnancy,6 cases were lost to follow-up,27 cases were aborted.Prenatal ultrasound and MRI examination indicated 6 cases of trachea compression.However,only 3 infants showed clinical symptoms due to trachea compression from born 5 cases.Conclusions Isolated vascular ring is the most common format and its diagnosis and type can be determined by prenatal ultrasound.Dynamic follow-up using ultrasound in pregnancy combined with MRI is helpful to assess the compression degree of trachea induced by vascular ring and prognosis.