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 includedthere 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 includedthe 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 .