Li Yuntao, Zhang Xiaohong, Yan Yani, Pei Qiuyan
Department of Obstetric Ultrasonography, Peking University People' Hospital, No. 11 of Nanda Street, Xicheng District, Beijing, 100044, China.
Department of Obstetric, Peking University People' Hospital, Beijing, 100044, China.
Pediatr Cardiol. 2018 Dec;39(8):1650-1655. doi: 10.1007/s00246-018-1945-1. Epub 2018 Aug 27.
The purpose of the study was to explore the prognosis, as well as antenatal ultrasonic features of isolated left subclavian artery (ILSCA) and isolated left brachiocephalic trunk (ILBCT) malformations, in order to improve prognosis and provide guidance for prenatal diagnosis. The origin and routing of cephalic and cervical vessels were observed in patients diagnosed with right aortic arch or right arterial duct arch in our hospital from March 2015 to March 2017, and the spectrum features related to ILSCA and ILBCT were analyzed. Fetuses diagnosed as ILSCA, or, and ILBCT were followed up for 3 months after birth. At the same time, a literature review was carried out for ILBCT and ILSCA in Pubmed. In our study, two cases with ILSCA and ILBCT were both diagnosed prenatally. They are not accompanied by other congenital malformations or chromosome abnormalities. No abnormality was found during postnatal follow-up except that left radial pulsation was weakened and blood pressure of the left upper limb decreased in baby with ILSCA. In baby with ILBCT, in addition to these abnormal changes, the left common carotid artery pulse disappearance too. In pubmed, three of 12 ILSCA or ILBCT did not have other congenital malformation or chromosome abnormalities. They were not diagnosed until the age of 3, 10, and 47 because of school exams or atypical symptoms, such as headaches, chest pain. Symptom of ILBCT or ILSCA without other abnormality is silent, and therefore they cannot be diagnosed timely after birth prenatal diagnosis is necessary for they can be treated in time.
本研究的目的是探讨孤立性左锁骨下动脉（ILSCA）和孤立性左头臂干（ILBCT）畸形的预后以及产前超声特征，以改善预后并为产前诊断提供指导。观察2015年3月至2017年3月在我院诊断为右主动脉弓或右动脉导管弓的患者头颈部血管的起源和走行，并分析与ILSCA和ILBCT相关的频谱特征。对诊断为ILSCA或ILBCT的胎儿出生后随访3个月。同时，在Pubmed上对ILBCT和ILSCA进行文献综述。在我们的研究中，2例ILSCA和ILBCT均在产前被诊断出来。它们不伴有其他先天性畸形或染色体异常。出生后随访期间，除ILSCA患儿左桡动脉搏动减弱、左上肢血压降低外，未发现其他异常。ILBCT患儿除上述异常改变外，左颈总动脉搏动也消失。在Pubmed上，12例ILSCA或ILBCT中有3例没有其他先天性畸形或染色体异常。由于学校体检或非典型症状，如头痛、胸痛，他们直到3岁、10岁和47岁才被诊断出来。ILBCT或ILSCA无其他异常的症状是隐匿的，因此出生后不能及时诊断，产前诊断很有必要，因为可以及时治疗。
