The differential diagnosis of double aortic arch and right aortic arch
with mirror-image branches in the fetus- A potential novel method
Abstract
Objective: To explore a new method of differential diagnosis of fetal
double aortic aorta (DAA) and right aortic arch with mirror-image
branches (RAA-MB). Methods: Clinical data and prenatal echocardiographic
features of the DAA (n = 22) and RAA-MB (n = 65) confirmed by postnatal
or autopsy findings were analyzed retrospectively. The angles between
the two aortic arches in the DAA group and between the right aortic arch
and the mirror branch were measured. The differences between both groups
and differential diagnosis value of the angles were compared and
analyzed based on the ROC curve. Results: Left-sided DAA’s proportion
(100%) was higher in the double aortic arch group (32.3%) than in the
RAA-MB group, (P < 0.05). The proportion of conotruncal anomalies is
higher in the RAA-MB group (64.6%) than in the DAA group (18.2%) (P <
0.05). There was a significant difference in the angles between both
groups (DAA: 50.3° ± 8.3° vs RAA-MB: 82.9° ± 13.8°) (P <
0.01). When the cut-off value was 62.8°, the sensitivity and specificity
of differential diagnosis were 95.5% and 96.9%, respectively.
Conclusions: Distinguishing the angle measurement between DAA and RAA-MB
is helpful in prenatal prognosis. We recommend a cutoff value of 62.8°.