双主动脉弓的超声心动图诊断价值及漏诊分析

目的：评价多普勒超声心动图对双主动脉弓的诊断价值，分析超声心动图漏诊的原因，旨在提高超声对双主动脉弓诊断的准确率。方法：本文总结了32例经CT、心血管造影及磁共振检查确诊为双主动脉弓的患儿，并与其超声心动图检测结果进行对照。结果：32例患儿中，超声诊断符合9例（占28％），超声漏诊23例（占72％）；23例漏诊患者中，7例超声诊断为左位主动脉弓，16例超声诊断为右位主动脉弓。32例中双侧主动脉弓均开放者14例，其中左、右侧主动脉弓均发育者10例，超声诊断符合5例；一侧主动脉弓发育良好，一侧主动脉弓缩窄者4例，超声诊断符合1例。32例中双主动脉弓左弓闭锁者17例，其中右弓发育良好者13例，超声诊断符合1例；右弓有缩窄者4例，超声诊断符合2例；32例中双主动脉弓右弓闭锁者1例，其左侧弓发育良好，超声未诊断。32例双主动脉弓患儿中，31例合并心内畸形，20例伴有气道狭窄。结论：超声心动图能较准确地诊断双主动脉弓，但易漏诊，当胸骨上窝切面能同时显示左颈总动脉和右颈总动脉时应警惕双主动脉弓的存在。

The diagnostic value and the misdiagnostic analysis in double aortic arch using echocardiography

Objective：To assess the value of Doppler eehocardiography in the diagnosis of double aortic arch （DAA）, and analyze the misdiagnosed to improve the correct rate of diagnosis. Methods： Angiocardiography, CT or MRI images were compared with echocardiographic findings in 32 patients with DAA. Results： Nine eases （28%） were diagnosed correcdy,23 eases （72%） were misdiagnosed. In misdiagnosed eases, 7 eases were diagnosed left aortic arch and 16 eases were diagnosed right aortic arch. In 32 patients, both aortic arches were patent in 14 cases, 10 of these both aortic arches developed （5 patients were diagnosed correctly by echocardiography）. Four of these patients, one aortic arch was development, the other was coarctation （ 1 patients was diagnosed correctly by echocardiography）. In 32 patients, the left aortic arch was atretie in 17 eases, 13 of these, right aortic arch developed（1 patients was diagnosed correctly by eehocardingraphy）. Four of these right aortic arch was coaretation （2 patients was diagnosed correedy by eehocardiography）. In 32 patients, the right aortic areh was atretic in 1 cases, and left aortic arch developed, this patient was misdiagnosed. In our study, 31 eases have associated cardiac deformations, 20 eases have traeheostenosis. Conclusion： DAA could be diagnosed accurately by Doppler echocardiography, but it was prone to be misdiagnosed. DAA might be considered while the left common carotid artery and the right common carotid artery were both showed in the suprastemal view by eehocardiography.