Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University; Beijing Key Laboratory of Maternal-Fetus Medicine in Fetal Heart Disease (BZ0308), No. 2, Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China.
Pediatr Cardiol. 2021 Aug;42(6):1405-1409. doi: 10.1007/s00246-021-02625-x. Epub 2021 Jul 13.
The objective of this study was to explore a new method for the differential diagnosis between fetal double aortic arch (DAA) and right aortic arch with mirror-image branches (RAA-MB). Clinical data and prenatal echocardiographic features of the DAA (n = 22) and RAA-MB (n = 65) confirmed by postnatal or autopsy findings were analyzed retrospectively. The angles between the two aortic arches in the DAA group and between the right aortic arch and the mirror branch were measured. The differences between the two groups and differential diagnosis value of the angles were compared and analyzed based on the receiver operating characteristic curve. The proportion of left-sided ductal arteriosus (100%) was higher in the DAA group than that (32.3%) in the RAA-MB group, (P < 0.05). The proportion of conotruncal anomalies is higher in the RAA-MB group (64.6%) than in the DAA group (18.2%) (P < 0.05). There was a significant difference in the angles between the groups (DAA: 50.3° ± 8.3° vs. RAA-MB: 82.9° ± 13.8°) (P < 0.01). When the cutoff value was 62.8°, the sensitivity and specificity of the differential diagnosis were 95.5% and 96.9%, respectively. Distinguishing the angle measurement between DAA and RAA-MB is helpful in prenatal prognosis. We recommend a cutoff value of 62.8°.
本研究旨在探索一种鉴别胎儿双主动脉弓（DAA）与镜像右主动脉弓伴镜像分支（RAA-MB）的新方法。回顾性分析经产后或尸检证实的 DAA（n=22）和 RAA-MB（n=65）的临床资料和产前心脏超声特征。测量 DAA 组两个主动脉弓之间以及右主动脉弓与镜像分支之间的夹角。基于受试者工作特征曲线比较两组之间的差异和夹角的鉴别诊断价值。DAA 组左导管（100%）的比例高于 RAA-MB 组（32.3%）（P<0.05）。RAA-MB 组的圆锥动脉干畸形比例（64.6%）高于 DAA 组（18.2%）（P<0.05）。两组之间的夹角存在显著差异（DAA：50.3°±8.3° vs. RAA-MB：82.9°±13.8°）（P<0.01）。当截点值为 62.8°时，鉴别诊断的敏感性和特异性分别为 95.5%和 96.9%。区分 DAA 和 RAA-MB 的夹角测量有助于产前预后。我们建议截点值为 62.8°。
