Song Mi Jin, Han Byoung Hee, Kim Young-Hwa, Yoon So Young, Lee Yoo Mi, Jeon Hye Su, Park Bo Kyung
Department of Radiology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
Department of Pediatrics, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
Ultrasonography. 2017 Jul;36(3):278-283. doi: 10.14366/usg.16046. Epub 2017 Feb 20.
The purpose of this study was to determine the frequency of aberrant right subclavian artery (ARSA) among unselected fetuses and to evaluate its association with chromosomal abnormalities and other congenital anomalies.
In all, 7,547 fetuses (gestational age, 20 to 34 weeks) were examined using routine antenatal sonography at our institution between April 2014 and September 2015. The right subclavian artery was assessed using grayscale and color Doppler ultrasonography in the transverse 3-vessel and tracheal view, and confirmed in the coronal plane.
ARSA was found in 28 fetuses (0.4%). Further, 27 of these 28 fetuses were euploid (96.4%). Trisomy 18 was the only chromosomal anomaly (3.6%) found in the study sample. ARSA was an isolated finding in 23 of the 28 cases (82.1%). In the remaining three cases (10.7%), ARSA was accompanied with extracardiac anomalies. Other cardiac defects were present in three cases (10.7%).
Isolated ARSA does not seem to be associated with a significantly increased risk of aneuploidy. However, the possibility of fetal karyotyping, which is a more invasive procedure, should be discussed in the light of the overall risk of the fetus.
本研究的目的是确定未选择的胎儿中迷走右锁骨下动脉(ARSA)的发生率,并评估其与染色体异常及其他先天性异常的关联。
2014年4月至2015年9月期间,在我们机构对7547例胎儿(孕周20至34周)进行常规产前超声检查。在横切的三血管和气管视图中使用灰阶和彩色多普勒超声评估右锁骨下动脉,并在冠状面进行确认。
发现28例胎儿(0.4%)存在ARSA。此外,这28例胎儿中有27例染色体数目正常(96.4%)。研究样本中仅发现18三体这一染色体异常(3.6%)。28例中有23例(82.1%)ARSA为孤立性发现。其余3例(10.7%)中,ARSA伴有心外异常。另有3例(10.7%)存在其他心脏缺陷。
孤立性ARSA似乎与非整倍体风险显著增加无关。然而,鉴于胎儿的总体风险,应讨论更具侵入性的胎儿核型分析的可能性。