Ivanitskaya Olga, Sologub Yulia, Tsayuk Yulia, Zagray Alexey, Kim Aleksei
Medical Genetics Department, Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russian Federation.
Department of Diagnostic Radiology, Kolomna Perinatal Center, Kolomna, Moscow Region, Russian Federation.
Ultrasound. 2020 Nov;28(4):255-259. doi: 10.1177/1742271X20941186. Epub 2020 Jul 14.
Congenital malformations of the right atrium-aneurysms and diverticulaare rare heart defects with only a few cases having been described prenatally. Early diagnosis of these anomalies is extremely important due to the possibility of such serious complications such as supraventricular arrhythmia, thromboembolic events and sudden death.
Although each of these anomalies is well known, there are still significant discrepancies in diagnosis. At the same time, there is no essential difference in the postnatal management of patients with right atrial aneurysms or diverticula. Treatment mode varies between centers and is selected individually depending on the presence of symptoms.
We discuss the problems of terminology, ultrasound criteria and prenatal differential diagnosis, anatomic and histological features and current limitations for the accurate diagnosis of right atrial aneurysms and diverticula in utero. As a clinical example, we describe a case of right atrial appendage aneurysm diagnosed in a fetus.
Considering the prenatal diagnostic difficulties and similar management of such patients after birth, we suggest avoiding the use of exact terms in the fetus, leaving the precise diagnosis for the postnatal period.
右心房先天性畸形——动脉瘤和憩室是罕见的心脏缺陷，产前仅有少数病例被描述。由于存在室上性心律失常、血栓栓塞事件和猝死等严重并发症的可能性，这些异常的早期诊断极为重要。
尽管这些异常中的每一种都为人熟知，但在诊断方面仍存在显著差异。同时，右心房动脉瘤或憩室患者的产后管理没有本质区别。治疗方式因中心而异，根据症状的有无进行个体化选择。
我们讨论了术语、超声标准和产前鉴别诊断、解剖和组织学特征以及目前在子宫内准确诊断右心房动脉瘤和憩室的局限性等问题。作为一个临床实例，我们描述了一例在胎儿中诊断出的右心耳动脉瘤病例。
考虑到产前诊断的困难以及此类患者出生后的类似管理，我们建议在胎儿期避免使用确切术语，将精确诊断留到出生后阶段。
