Department for Diagnosis and Prevention of Congenital Malformation, Fetal Cardiology Center type C in Lodz, Medical University of Lodz, Lodz, Poland.
Ultrasound Med Biol. 2011 Nov;37(11):1808-13. doi: 10.1016/j.ultrasmedbio.2011.06.002. Epub 2011 Aug 15.
Interruption of the aortic arch (IAA) is difficult to detect and diagnose in utero. However, prenatal diagnosis may be beneficial because IAA is rapidly fatal (median age, 10 d) if left uncorrected. Our objective was to review the direct and indirect echocardiographic markers associated with IAA, focusing on the importance of the three-vessel view (3VV), which is obtained during routine ultrasound examination to rule out malformations. We analyzed the fetal echocardiograms of nine fetuses and compared them with 56 normal controls. In each fetus, there was a large discrepancy between the diameter of the larger, dilated pulmonary artery (PA) and smaller, narrow aortic arch (Ao). The calculated ratio of PA/Ao in fetuses with IAA was 2.6 ± 0.4 compared with 1.1 ± 0.09 in normal controls (p < 0.0001). The calculated ratio of PA/Ao in fetuses with IAA type A was 2.1 ± 0.09 and IAA type B 2.9 ± 0.2 (p = 0.0007). Discrepancy between PA/Ao diameters should raise the suspicion of aortic arch anomalies and a large discrepancy is a nearly pathognomonic sign of IAA type B.
主动脉弓中断（IAA）在子宫内很难检测和诊断。然而，产前诊断可能是有益的，因为如果不进行矫正，IAA 会迅速致命（中位年龄为 10 天）。我们的目的是回顾与 IAA 相关的直接和间接超声心动图标志物，重点关注三血管切面（3VV）的重要性，该切面是在常规超声检查中获得的，用于排除畸形。我们分析了 9 例胎儿的超声心动图，并将其与 56 例正常对照组进行了比较。在每个胎儿中，扩张的肺动脉（PA）的直径与狭窄的主动脉弓（Ao）的直径之间存在很大差异。IAA 胎儿的 PA/Ao 比值为 2.6±0.4，而正常对照组为 1.1±0.09（p<0.0001）。IAA 型 A 的 PA/Ao 比值为 2.1±0.09，IAA 型 B 为 2.9±0.2（p=0.0007）。PA/Ao 直径的差异应引起对主动脉弓异常的怀疑，而较大的差异几乎是 IAA 型 B 的特征性标志。
