Prenatal Ultrasound Diagnosis Of Congenital Vascular Rings

Objective This study aims to summarize prenatal ultrasound features of congenital vascular ring, evaluate the application value of ultrasound in diagnosis of congenital vascular ring and improve prenatal detection rate of congenital vascular ring.Material and methods Analysis from November 2013 to December 2015 during in our hospital prenatal ultrasound diagnosis of 35 cases of congenital vascular ring, analysis congenital vascular ring in fetal three vascular-vessel-tracheal view, three-vessel pulmonary artery branch section, tracheal coronal, long axis view of the aortic arch ultrasound features, performance and color Doppler imaging contrast the results of imaging after birth or autopsy were summarized their prenatal ultrasound diagnostic clues, and misdiagnosis reasons analysis.Results 1. 27 cases of 35 cases of congenital vascular ring were complete vascular ring, right aortic arch with aberrant left subclavian artery were most common vascular ring, a total of 22 cases accounted for 62.8%(22/35), double aortic arch in 4 cases, accounting for 14.2 %(5/35); incomplete vascular ring in 8 cases, including the left aortic arch with aberrant right subclavian artery 7 cases, accounting for 20%(7/35), pulmonary artery sling in 1 case, accounting for 2.8%(1/35). 2. 35 cases including 27 cases were birth and 8 cases were abortion; 31 cases after prenatal MRI or imaging confirmed after birth; 4 cases were confirmed by abortion, including two cases of double aortic arch, one case of left aortic arch with aberrant right subclavian artery and one case of pulmonary artery sling. 3. 33 cases of fetal vascular rings were correctly diagnosed by ultrasound(33/35), one case of left aortic arch with aberrant right subclavian artery was missed diagnosed and one case of double aortic arch misdiagnosed as right aortic arch with mirror image branching brachiocephalic artery.Conclusion 1. Fetal blood vessels by three- trachea view, the three branches of the pulmonary vascular section, long axis view of the aortic arch, tracheal coronal section, prenatal ultrasound can accurately diagnose congenital vascular ring and its type. Through the coronary trachea the scanning view, it can be determined whether the trachea by pulling airway stenosis without obvious deformation. Due to their different other cardiac pathology associated with congenital vascular ring and outer malformations and chromosomal abnormalities chance different, so each fetus to respond in detail screening system when detection of congenital vascular rings exist, and recommended that related chromosomal examination, including fetal karyotype analysis and 22q11 gene microdeletion detection.2. The three-vessel- trachea view and three branches of the pulmonary vascular view of Doppler imaging technology application can provide an important basis for the diagnosis of congenital vascular rings, to avoid misdiagnosis and missed diagnosis occurs, especially when we detect the right aortic arch need to alert the presence of double aortic arch. 3. Prenatal US have a high clinical value in the diagnosis of congenital vascular rings,prenatal US in promoting prenatal and postnatal care, prenatal guidance also had a great social values and its effect can not be underestimated.