Gao Junxue, Zhu Jiaan, Pei Qiuyan, Li Jianguo
Department of Ultrasonography, Peking University People's Hospital, Beijing, China.
Department of Obstetrics and Gynecology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China.
Arch Gynecol Obstet. 2017 May;295(5):1291-1295. doi: 10.1007/s00404-017-4310-3. Epub 2017 Mar 27.
This study sought to evaluate the fetal echocardiography features of isolated right aortic arch (RAA) with mirror-image branching and to improve the rate and accuracy of prenatal diagnosis of this condition.
We reviewed fetal echocardiograms from all cases of isolated RAA with mirror-image branching diagnosed at our institution between August 2012 and December 2015 and classified these cases into normal and abnormal types of ductus arteriosus based on the course of the arterial duct arch. We confirmed the diagnoses by postnatal echocardiography.
A total of 11 cases of isolated RAA with mirror-image branching, with the left ductus and the descending aorta located on the left side of the spine, were diagnosed using fetal echocardiography. Ten cases involved normal ductus arteriosus, with the left ductus connecting the left pulmonary artery to the descending aorta, five of which were referred to our institution for suspicions of double aortic aorta. 1 case involved abnormal ductus arteriosus, with the left ductus connecting the left pulmonary artery to the left innominate artery.
RAA with mirror-image branching can be detected via fetal echocardiography, which can reveal the relationship between of the aortic arch and the trachea and can enable the identification of the course of brachiocephalic branching. The identification of isolated RAA with mirror-image branching is crucial for distinguishing this condition from other types of aortic arch anomalies, particularly double aortic aorta, which can have a rather different prognosis.
本研究旨在评估孤立性镜像分支右位主动脉弓（RAA）的胎儿超声心动图特征，提高该疾病产前诊断的率和准确性。
我们回顾了2012年8月至2015年12月在本机构诊断的所有孤立性镜像分支RAA病例的胎儿超声心动图，并根据动脉导管弓的走行将这些病例分为动脉导管正常和异常类型。我们通过产后超声心动图确诊。
使用胎儿超声心动图共诊断出11例孤立性镜像分支RAA，左导管和降主动脉位于脊柱左侧。10例动脉导管正常，左导管将左肺动脉与降主动脉相连，其中5例因怀疑双主动脉弓转诊至本机构。1例动脉导管异常，左导管将左肺动脉与左无名动脉相连。
镜像分支RAA可通过胎儿超声心动图检测到，它可以揭示主动脉弓与气管之间的关系，并能够识别头臂分支的走行。识别孤立性镜像分支RAA对于将这种情况与其他类型的主动脉弓异常，特别是预后可能截然不同的双主动脉弓区分开来至关重要。
