Department of Ultrasoud Diagnosis, Children's Hospital of Hebei Province, Hebei Medical University, Shijiazhuang, China.
Cardiovasc Ultrasound. 2021 Jan 14;19(1):8. doi: 10.1186/s12947-021-00237-2.
The purpose of this study was to explore echocardiographic views and methods of aortic arch anomalies in infants, so as to improve the screening sensitivity and diagnostic accuracy.
140 children with abnormal aortic arch diagnosed by ultrasound in Children's Hospital of Hebei Province from January 2014 to December 2019 were selected for retrospective analysis. All were confirmed by surgery or/and computerized tomography angiography. Series of views for aortic arch (the three-vessel and tracheal view, aortic arch short axis view, left aortic arch long axis view, aortic arch long axis continuous scan views) were performed in all cases on the basis of the routine views of echocardiography. The screening sensitivity and diagnostic coincidence rate of different echocardiographic views for aortic arch anomalies were analyzed.
Among the 140 infants, right aortic arch were 21 cases (6/21 were accompanied by mirror branch and 15/21 were with aberrant left subclavian artery). Left aortic arch with aberrant right subclavian artery were 2 cases, and double aortic arch with both arches open were 20 cases. Double aortic arch with left arch atresia were 2 cases, and atresia of the proximal aorta with aortic arch dysplasia was 1 case. Coarctation of the aorta were 67 cases, and interruption of aortic arch were 27 cases. All the patients were correctly diagnosed except that 2 infants with interruption of aortic arch were incorrectly diagnosed as coarctation of the aorta, and 1 infant with coarctation of the aorta was misdiagnosed as interruption of aortic arch by echocardiography. The screening sensitivities of four views and four-view combination for abnormal aortic arch were 99.3, 73.6, 87.1, 99.3, and 100%; the diagnostic coincidence rates were 85.7, 27.1,66.4, 95.0%, and 97.9% respectively. On the basis of traditional left aortic long axis view, other three views had their own advantages. The screening sensitivity and diagnostic coincidence rate of four-view combination were significantly improved.
The three-vessel trachea view is simple and feasible, which is suitable for screening abnormal aortic arch. The combination of four views conduces to improving screening sensitivity and diagnostic accuracy of aortic arch abnormalities.
本研究旨在探讨超声心动图在婴儿主动脉弓异常中的观察方法，以提高筛查的敏感性和诊断的准确性。
选取 2014 年 1 月至 2019 年 12 月河北省儿童医院经超声诊断为主动脉弓异常的 140 例患儿进行回顾性分析，均经手术或/和计算机断层血管造影术证实。所有患儿均在常规超声心动图的基础上进行主动脉弓系列切面（三血管气管切面、主动脉弓短轴切面、左主动脉弓长轴切面、主动脉弓长轴连续扫描切面）检查。分析不同超声心动图切面诊断主动脉弓异常的筛查敏感性和诊断符合率。
140 例患儿中，右位主动脉弓 21 例（21 例镜像分支，15 例合并左迷走锁骨下动脉异常），左位主动脉弓伴右迷走锁骨下动脉 2 例，双主动脉弓均开放 20 例，左弓闭锁 2 例，主动脉弓发育不良合并主动脉近端狭窄 1 例。主动脉缩窄 67 例，主动脉弓中断 27 例。除 2 例主动脉弓中断误诊为主动脉缩窄，1 例主动脉缩窄误诊为主动脉弓中断外，其余患儿均正确诊断。四切面及四切面联合诊断主动脉弓异常的筛查敏感性分别为 99.3%、73.6%、87.1%、99.3%、100%；诊断符合率分别为 85.7%、27.1%、66.4%、95.0%、97.9%。在传统左主动脉长轴切面的基础上，其他三切面各有优势，四切面联合可明显提高筛查敏感性和诊断符合率。
三血管气管切面简单可行，适用于主动脉弓异常的筛查。四切面联合有助于提高主动脉弓异常的筛查敏感性和诊断准确性。
