Abstract:
Objective To assess the value of continuous transverse scanning (CTS) combined with continuous coronary scanning (CCS) in the differential diagnosis between fetal right aortic arch with mirror branch (MB-RAA) and double aortic arch (DAA).
Methods This is a cohort study conducted at our hospital between January 2017 and February 2020. Forty-two cases of MB-RAA and DAA fetuses diagnosed by CTS were included in the study. CTS combined with CCS was used to review the diagnosis. The pregnant women were followed until induced labor or fetus birth. The diagnostic accuracy rate for prenatal DAA by CTS and CTS combined with CCS was compared.
Results There were 39 cases of MB-RAA, including 22 cases of isolated MB-RAA, 15 cases of MB-RAA with intracardiac malformations, 6 cases of MB-RAA with extracardiac malformations (among them, there were cases with both intracardiac and extracardiac malformations), and 3 cases of DAA who had no other abnormalities. CTS combined with CCS was used to review the diagnosis, and it finally diagnosed 32 cases of MB-RAA and 10 cases of DAA, including 7 cases of isolated MB-RAA diagnosed by CTS alone. Thirteen cases underwent induced labor, and 29 cases had full-term delivery, including 10 cases of DAA, 17 cases of isolated MB-RAA, 1 case of MB-RAA with tetralogy of Fallot, and 1 case of MB-RAA with mild lateral ventriculomegaly. The case of MB-RAA with tetralogy of Fallot underwent a surgery after birth and our diagnosis was confirmed by surgery. The case of MB-RAA with mild lateral ventriculomegaly and 16 cases of isolated MB-RAA had no compression symptoms, and one case of isolated MB-RAA diagnosed by prenatal ultrasound presented wheezing 6 months after birth but CT examination found that it was DAA, which was then treated by surgery. Among ten neonates diagnosed prenatally as having DAA, two had compression symptoms after birth and underwent surgical treatment, and eight having no compression symptoms were confirmed by ultrasound or CT. The accuracy of CTS combined with CCS in the prenatal diagnosis of DAA was significantly higher than that of CTS (10/42 vs 3/42, P=0.016).
Conclusion CTS combined with CCS can improve the prenatal diagnostic accuracy for DAA and facilitate the differential diagnosis between DAA and MB-RAA.
Key words:
Continuous transverse scanning,
Continuous coronary scanning,
Right aortic arch with mirror branch,
Double aortic arch
Xiaowei Xue, Chao Zhang, Yani Yan, Zhenjuan Yang, Yuntao Li, Xiaohong Zhang, Qiuyan Pei. Value of continuous transverse scanning combined with continuous coronary scanning in diagnosis of fetal double aortic arch[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(01): 23-27.