摘要目的 探讨三血管气管切面和主动脉弓降部冠状切面诊断胎儿右位主动脉弓及分型的价值.方法 回顾性分析44例胎儿右位主动脉弓的超声心动图资料与随访结果,总结右位主动脉弓在三血管气管切面和主动脉弓降部冠状切面的声像图特点.结果 44例胎儿右位主动脉弓中右位主动脉弓伴左锁骨下动脉迷走和左位动脉导管(导管连接迷走左锁骨下动脉)27例(61.36%),形成"U"形血管环.镜面右位主动脉弓17例(38.64%),其中3例伴左位动脉导管(导管连接降主动脉)形成"U"形血管环;余14例中,1例伴左位动脉导管(导管连接左无名动脉),8例伴动脉导管缺如,5例伴右位动脉导管,均未形成血管环.镜面右位主动脉弓多合并其他复杂心内畸形,而右位主动脉弓伴左锁骨下动脉迷走较少合并心内畸形.结论 三血管气管切面可简单直观诊断右位主动脉弓;主动脉弓降部冠状切面对右位主动脉弓的分型有重要临床价值.

abstractsObjective To explore the value of three-vessel and trachea(3VT) view plus aortic arch coronal section in ultrasonic diagnosis and classification of fetal right aortic arch(RAA).Methods Echocardiography data and follow-up results of 44 fetuses with RAA were retrospectively analyzed.Sonographic features on 3VT view and aortic arch coronal section were summarized.Results Among 44 fetuses with RAA,27 cases(61.36%) were RAA with aberrant left subclavian artery(ALSA) and the left ductus arteriosus(LDA) connecting the ALSA and U-shaped vascular ring was formed;17 cases(38.64%) were mirror right aortic arch(MRAA).Among 17 cases with MRAA,3 cases were with LDA connecting the descending aorta(DAO) and U-shaped vascular ring was formed;1 case was with LDA connecting the left innominate artery(LINA),8 cases were with absent ductus arteriosus(ADA),5 case were with right ductus arteriosus(RDA),no vascular ring was formed.Parts of MRAA were combined with other complex intracardiac abnormalities.RAA-ALSA-LDA were rarely combined with intracardiac abnormalities.Conclusions 3VT view is simple and intuitive for diagnosing RAA.Aortic arch coronal section has great clinical value in determining the concrete type of RAA.