Abstract
Objectives: This study aims to explore the clinical value of prenatal ultrasonography in the diagnosis of the common arterial trunk (CAT) classification and associated deformities.
Materials and methods: The two-dimensional ultrasound images spatiotemporal image correlations (STICs) and clinical data of 108 foetuses diagnosed with CAT malformations were retrospectively analysed, their CAT types were classified, and the correlations between these different types and foetal malformations and pregnancy outcomes were analysed.
Results: Among the 108 foetuses, there were 47 cases (43.5%) of type A1, 51 cases (47.3%) of type A2, 9 cases (8.3%) of type A3 and 1 case of type A4 (0.9%), of which 22 cases (20.4%) were isolated CAT, 56 cases (51.8%) had complex intra-cardiac structural abnormalities, 30 cases (27.8%) had intra-cardiac or extra-cardiac structural abnormalities, 17 cases had 1 other system abnormality, and 5 cases had 2 other system abnormalities. Four cases were combined with 3 other system abnormalities, while 4 cases were combined with 4 other system abnormalities, among which the facial and physical abnormalities had the highest incidence (40.0%). The STIC images were completely displayed in 88 cases (81.5%). Isolated CAT and CAT combined with other malformations were significantly correlated with foetal pregnancy outcomes (P < 0.05).
Conclusions: Prenatal ultrasonography had a high clinical application value for classifying CAT. Pregnancy outcomes were highly correlated with the classification and combined intra-cardiac and extra-cardiac structural malformations. The early assessment of foetal prognosis before birth has great value for clinical intervention.
KEYWORDS: prenatal ultrasound; common arterial trunk; foetus; spatio-temporal image correlation
1 | INtroduction
Common arterial trunk (CAT) is a rare congenital heart defect (CHD), accounting for about 1% of CHD foetuses.1 CAT represents an early stage of the development of primitive arterial septum during embryonic development. Therefore, only one large artery leading from the bottom of the embryonic heart is preserved, and the ventricular blood is pumped into systemic circulation, pulmonary circulation and coronary circulation through a set of semilunar valves’ instead.2 The prognosis of CAT is extremely poor, as 50% of children die within 1 month of birth due to heart failure and other causes and only 15%–30% survive for more than 1 year.3 Therefore, an early prenatal diagnosis guides the correct clinical treatment. This study retrospectively analysed CAT prenatal ultrasound images, spatiotemporal image correlation (STIC) images and their associated deformities to improve the understanding of CAT and reduce perinatal mortality.