论文部分内容阅读
目的:探讨胎儿双侧锁骨下动脉切面观察左无名静脉与双侧锁骨下动脉的位置关系在筛查有无胎儿迷走右锁骨下动脉(ARSA)的价值。方法:2016年5月至12月,共计3125例孕20~26周筛查胎儿纳入本前瞻性研究,根据常规三血管气管切面(3VT)情况及双侧锁骨下动脉切面观察左无名静脉与双侧锁骨下动脉的位置关系判断有无ARSA。结果:共有3103例3VT切面正常,在双侧锁骨下动脉切面显示左无名静脉与双侧锁骨下动脉位置关系超声表现为:左、右锁骨下动脉对称分布且起始部紧贴左无名静脉后上方,右锁骨下动脉位于气管前,呈“S”形;共有22例3VT切面异常,其中12例ARSA,该12例ARSA的双侧锁骨下动脉切面显示左无名静脉与双侧锁骨下动脉位置关系超声表现为:紧贴左无名静脉后上方仅见左锁骨下动脉,而右锁骨下动脉远离左无名静脉走行于气管后方,其起始部走向变直与左无名静脉平行,3VT切面显示ARSA为主动脉弓左侧的最后一个分支。结论:ARSA的胎儿左无名静脉与双侧锁骨下动脉位置关系超声表现具有特征性,发现3VT切面异常时可切换至左无名静脉与双侧锁骨下动脉切面,有助于快速诊断有无ARSA。
Objective: To investigate the value of fetal left vagus subclavian artery section to observe the relationship between the left anterior descending artery and the bilateral subclavian artery in screening for the presence of fetal left vagus subclavian artery (ARSA). METHODS: From May to December 2016, a total of 3,125 pregnant fetuses aged 20 to 26 weeks were enrolled in this prospective study. According to the conventional trivascular tracheal section (3VT) and the bilateral subclavian artery section, the left anonymous vein and the double The location of the side of the subclavian artery to determine the presence or absence of ARSA. Results: A total of 3103 cases of 3VT section normal, the bilateral subclavian artery section showed the left anonymous vein and the bilateral subclavian artery ultrasound showed: the left and right subclavian artery symmetrical distribution and the beginning of the Ministry of close to the left anonymous vein Above the right subclavian artery in front of the trachea was “S” shape; a total of 22 cases of 3VT section abnormalities, of which 12 cases of ARSA, the 12 cases of ARSA bilateral subclavian artery section showed the left anonymous vein and bilateral subclavian The relationship between the arterial position ultrasound showed: close to the left anonymous vein only after the top of the left subclavian artery, while the right subclavian artery away from the left anonymous vein in the trachea, the starting part of the straight and left anonymous vein straight parallel to the 3VT section display ARSA is the last branch to the left of the aortic arch. CONCLUSIONS: The positional relationship between the left anterior descending artery and the bilateral subclavian artery of ARSA is characterized by ultrasonographic findings. It is found that ARSA can switch to the left anonymous vein and the bilateral subclavian artery when the 3VT is abnormal, which is helpful for the rapid diagnosis of ARSA.