Prenatal diagnosis of anomalous origin of one pulmonary artery branch from the aorta and unilateral absence of pulmonary artery by echocardiography / 中华超声影像学杂志

ABSTRACT

Objective To improve the prenatal diagnosis and differential diagnosis ability for anomalous origin of one pulmonary artery branch from the aorta ( AOPA ) and unilateral absence of pulmonary artery ( U APA ) by comparing and analyzing different types of fetal echocardiography features . Methods Fetal echocardiographic features were analyzed retrospectively in fetus with prenatal diagnosis of U APA or AO PA between June 2012 and December 2018 ,and the different types of fetal echocardiography characteristics and main points of identification were summarized . Results A total of 6 fetuses with AOPA and 6 fetuses with U APA were diagnosed .Among the 6 fetuses with AOPA ,5 cases were anomalous origin of right pulmonary artery from the aorta ( AORPA ) ,including 3 cases with isolated AORPA and 2 cases combined with Berry syndrome ,and 1 case was anomalous origin of left pulmonary artery from the aorta ( AOLPA ) with an absent pulmonary valve . All 6 cases of AOPA had proximal form . Among the 6 fetuses with U APA ,4 cases were isolated unilateral absence of right pulmonary artery ,1 case was isolated unilateral absence of left pulmonary artery and 1 case was unilateral absence of left pulmonary artery combined with tetralogy of Fallot ( T OF) . T he main common characteristic sonographical findings included :there was no confluence at the bifurcation of the main pulmonary artery on multiple view s ,and the affected pulmonary branch was not attached to the main pulmonary artery . T he different characteristic sonographical findings in fetus included :the affected pulmonary artery of AO PA arosed from the right posterior or left posterior portion of the ascending aorta on three vessels and trachea view ( 3V T ) and long axial view of left ventricle , and 3V T and the coronary view of brachiocephalic trunk artery showed that the abnormal origin of pulmonary artery branch of U APA connected with the root of brachiocephalic trunk artery by the ipsilateral vertical arterial duct ( DA ) ,and color Doppler flow imaging showed that the blood flow of the affected pulmonary artery branch was isolated in the pulmonary field . Conclusions AOPA and UAPA have many similarities in the characteristics of fetal echocardiography . 3V T and long axial view of left ventricle are the best view s for displaying proximal AOPA ,3VT and the coronary view s of the root of brachiocephalic trunk artery are the best view s for displaying UAPA .