迷走右锁骨下动脉课件.ppt

迷走右锁骨下动脉课件
1
aortic arch 主动脉弓
brachiocephalic trunk 头臂干
common carotid artery 颈总动脉
subclavian 锁骨下的
ductus arent research groups demonstrated a higher prevalence of ARSA in Down-syndrome fetuses at present the exact quantification of this phenomenon remains unclear.
Objectives
To estimate the prevalence of aberrant right subclavian artery (ARSA) in fetuses with Down syndrome.
To assess the prevalence of ARSA in euploid fetuses, the feasibility of ultrasound evaluation of the right subclavian artery (RSA) in the first and second trimesters of pregnancy, the performance of ARSA in screeening for trisomy 21 and its association with other abnormalities.
Methods
A systematic search of the literature from inception until July 2019 was performed in PubMed, EMBASE and MEDLINE to identify relevant articles.
The search included the following medical subjects heading terms alone or in different combinations: Down syndrome, trisomy 21, ARSA, aberrant right subclavian artery, ultraound and prenatal diagnosis.
Ultrasound evaluation of the RSA course and origin in the first and second trimesters of pregnancy was feasible in 85% and 98% of cases (first and second trimester, respectively) and it was directly related to sonographic experience and fetal crown-rump lenghth and inversely related to maternal body mass index.
3. Feasibility of ARSA
Chaoui R ,, Rake A ,, Heling K S. Aortic arch with four vessels: aberrant right subclavian artery[J]. Ultrasound in Obstetrics & Gynecology, 2019, 31(1):115-117.
In more than 20% of fetuses with ARSA there was an association with other abnormalities but ARSA seemed to be an independent marker of trisomy 21.
4. ARSA and associated anomalies
Corbacioglu Esmer A, Gul A, Nehir A, et al. Detection Rate of Trisomy 21 in Fetuses with Isolated and Non-Isolated Aberrant Right Subclavian Artery.[J]. Fetal Diagnosis & Therapy, 2019, 34(3):140-145.
Conclusions
ARSA appears to be a clinically useful prenatal ultrasound