Prenatal Echocardiography Diagnosis And Prognosis Analysis Of Congenital Vascular Rings

Objective:To discuss the value of prenatal echocardiography in diagnosis and prognostic evaluation of the congenital vascular ring by follow up and analyzing the general situation of CVR cases diagnosed by prenatal echocardiography,the image features of echocardiography,pregnancy outcome,and the development and digestion of respiratory system after birth.Materials and Methods:One hundred and fourty-two cases of congenital vascular rings were diagnosed by the prenatal fetal heart screening and fetal heart consultation in Suzhou Municipal Hospital from January 2017 to March 2018.The ultrasound image,Doppler features and prenatal and postpartum imaging findings of the multi-section of three vessels were analyzed.The autopsy results were analyzed and the causes of missed diagnosis or misdiagnosis were analyzed.Result:(1)Eighty-nine cases of complete vascular ring in all 142 congenital vascular ring,in which the right aortic arch with left catheter is 82 cases,accounting for 57.04%(82/142),accounting for the incidence was the highest in the complete vascular ring;the double aortic arch 7cases,the right aortic arch mirror branch 1 cases,52 case of the incomplete vascular ring was the left aortic arch with the right subclavian artery;(2)Thirty-two cases of congenital vascular ring were combined with other cardiac malformation,another 1 case with out cardiac malformation.(3)Twenty-six cases in 90 cases of complete vascular ring were induced and 1 case were misdiagnosed.No symptoms were found in postpartum follow-up;5 cases in 52 cases with incomplete vascular ring were induced,and confirmed by autopsy,and no obvious trachea and esophagus compression symptoms after postpartum follow-up.Conclusion:(1)Prenatal ultrasound can accurately diagnose congenital vascular rings and classify them with observation of the three vascular-tracheal section of the fetus,the long axis of the aortic arch,the section of the trachea coronal and the other non-standard tangent surfaces.In addition,congenital vascular rings are easily associated with other cardiac and external malformations and chromosomal abnormalities.Therefore,comprehensive prenatal consultation should be carried out for the fetus with congenital vascular rings.(2)The application of color Doppler and power Doppler on the multiline of the three vessels provides an important basis for the prenatal diagnosis of congenital vascular rings,especially the differential diagnosis of the double aortic arch and the right aortic arch mirror branch,and the avoidance of the missed diagnosis of the subclavian artery.(3)Prenatal ultrasound is valuable for the diagnosis of congenital vascular rings.Different types of congenital vascular rings have different sonographic features on the multi-section of three vessels,which have great reference value for clinical diagnosis,and provide important reference information for perinatal consultation and postpartum clinical assistance.