Yang Haiyan, Zhu Xu, Wu Chun, Zhao Xiaodong, Ji Xiaojuan
Department of Ultrasound, Children's Hospital of Chongqing.
State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Key Laboratory of Biomedical Engineering, Chongqing.
Medicine (Baltimore). 2020 Feb;99(9):e19297. doi: 10.1097/MD.0000000000019297.
To evaluate the utility of echocardiography (echo) in the diagnosis of persistent fifth aortic arch (PFAA), a very rare congenital aortic arch anomaly, and to compare echo and computed tomography angiography (CTA) imaging findings to improve our understanding of this anomaly.Data on the clinical diagnosis, imaging findings, and clinical management of PFAA were retrospectively analyzed in 10 suspected cases of PFAA admitted to our hospital between January 2012 and February 2017. We compared echo as a first line examination modality, and CTA and surgery results as the gold standard. Weinberg's classification was used to classify the type of PFAA.All patients (100%) received echo examination, eight patients (80%) received CTA examination, and four patients (40%) received sternotomy surgery; all recovered well after surgery. According to Weinberg's classification, 2, 6, and 2 cases (20%, 60%, and 20%) were classified as Type A, B, and C, respectively. Echo was able to diagnose 5 cases of PFAA (1 Type A case and 4 Type B cases) in the first instance. The diagnostic conformance rate of echo was 62.5% after comparisons with CTA and surgery results.The clinical manifestation of PFAA was atypical, and its diagnosis depended primarily on medical imaging. Echo has a relatively high diagnostic accuracy for PFAA, which is very valuable for its early detection.
为评估超声心动图（echo）在诊断持续性第五主动脉弓（PFAA，一种非常罕见的先天性主动脉弓异常）中的效用，并比较超声心动图和计算机断层血管造影（CTA）的影像学表现，以增进我们对这种异常的理解。回顾性分析了2012年1月至2017年2月期间我院收治的10例疑似PFAA患者的临床诊断、影像学表现及临床治疗数据。我们将超声心动图作为一线检查方式，将CTA和手术结果作为金标准进行比较。采用温伯格分类法对PFAA的类型进行分类。所有患者（100%）均接受了超声心动图检查，8例患者（80%）接受了CTA检查，4例患者（40%）接受了胸骨切开术；所有患者术后恢复良好。根据温伯格分类法，分别有2例、6例和2例（20%、60%和20%）被分类为A型、B型和C型。超声心动图最初能够诊断出5例PFAA（1例A型和4例B型）。与CTA和手术结果比较后，超声心动图的诊断符合率为62.5%。PFAA的临床表现不典型，其诊断主要依赖于医学影像学。超声心动图对PFAA具有较高的诊断准确性，对其早期发现非常有价值。
