Hata Toshiyuki, Koyanagi Aya, Takayoshi Riko, Miyake Takahito, Nakai Yuichiro, Tani Kazumasa, Hayata Kei, Masuyama Hisashi
Department of Obstetrics and Gynaecology, Miyake Clinic, Okayama, Japan.
Department of Perinatology and Gynaecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan.
Case Rep Perinat Med. 2022 Feb 1;11(1):20210066. doi: 10.1515/crpm-2021-0066. eCollection 2022 Jan.
A significant discrepancy between a large ductus arteriosus and a smaller aorta at their connection is key to diagnose coarctation of the aorta (CoA) at 14-16 weeks of gestation. CoA was associated with persistent left superior vena cava (PLSVC) in 21.3% of fetuses. HDlive Flow findings for CoA or PLSVC were obtained only in the third trimester of pregnancy. To the best of our knowledge, there has been no report on the prenatal findings of CoA and PLSVC using HDlive Flow with spatiotemporal image correlation (STIC) before 20 weeks of gestation.
We present the trans-abdominal HDlive Flow features of CoA and PLSVC at 14 weeks of gestation. With a three-vessel trachea view on multiplanar view using color Doppler with STIC, PLSVC on the left side of the pulmonary artery was noted, and a narrowing aortic isthmus was suspected. A narrowing isthmus was also suspected with an aortic arch view. HDlive Flow clearly showed the spatial relationships among the right superior vena cava, aorta with narrowing isthmus, pulmonary artery, and PLSVC. A preductal 'shelf' was also suspected. No other fetal anomaly was noted. Neonatal echocardiography after delivery confirmed CoA and PLSVC.
To the best of our knowledge, this is the first report on HDlive Flow features of fetal CoA and PLSVC using STIC early in the second trimester of pregnancy.
在妊娠14 - 16周时，大动脉导管与较小的主动脉在连接处存在显著差异是诊断主动脉缩窄（CoA）的关键。在21.3%的胎儿中，CoA与永存左上腔静脉（PLSVC）相关。CoA或PLSVC的高清实时血流（HDlive Flow）检查结果仅在妊娠晚期获得。据我们所知，尚无关于妊娠20周前使用高清实时血流联合时空图像相关技术（STIC）对CoA和PLSVC进行产前检查结果的报道。
我们展示了妊娠14周时CoA和PLSVC的经腹高清实时血流特征。在多平面视图下，通过彩色多普勒联合STIC获得三血管气管视图，发现肺动脉左侧有PLSVC，并怀疑主动脉峡部狭窄。在主动脉弓视图下也怀疑有峡部狭窄。高清实时血流清晰显示了右上腔静脉、有狭窄峡部的主动脉、肺动脉和PLSVC之间的空间关系。还怀疑有动脉导管前“嵴”。未发现其他胎儿异常。产后新生儿超声心动图证实了CoA和PLSVC。
据我们所知，这是关于妊娠中期早期使用STIC对胎儿CoA和PLSVC进行高清实时血流特征的首次报道。
