Objective To evaluate the role of combination of three-vessel views in ultrasound diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.Methods The data of 66 cases of fetal aortic arch and pulmonary arterial branch anomalies were retrospectively analysed,including echocardiographic data,autopsy and operation records and postnatal follow-up results.Echocardiogaphic features and display frequencies on three vessels and trachea view(3VT),three vessels view(3VV)and three vessels and pulmonary arterial branches view(3VP)were summarized.Results There were 52 cases of aortic arch abnormalities,including 32 cases of right aortic arch with left ductus arteriosus,4 cases of double aortic arch,7 cases of aberrant right subclavian artery,6 cases of coarctation of aorta and 3 cases of interruption of aortic arch.Fourteen cases were diagnosed pulmonary aterial branch abnormalities,including 1 0 cases of crossed pulmonary arteries,2 cases of anomalous origin of left pulmonary artery from aortic arch and 2 cases of pulmonary artery sling.The display frequencies of fetal aortic arch and pulmonary arterial branch anomalies on 3VT,3VV and 3VP were 80.3%,19.7% and 39.4%.Conclusions The combination of three-vessel views is of great value in prenatal diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.

Teaching model plays an important role in clinical education. Problem based learning (PBL) model, with an outstanding feature of stimulating the learning enthusiasm of students, was applied by many American colleges. American College of Acupuncture&Oriental Medicine (ACAOM) combined PBL teaching model with traditional lecture based learning (LBL) model, which had achieved good results. In this article, PBL model and its characters were explored via qualitative case analysis, to provide reference for universities and colleges of traditional Chinese medicine on clinical education.

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of partial and intermediate atrioventricular septal defect (AVSD). MethodsUltrasound images of11casesof partialandintermediateAVSDconfirmedbyautopsy orpostnatal echocardiography were retrospectively analyzed and the characteristics were summarized. Results Fetal echocardiography of seven cases of partial AVSD and four cases of intermediate AVSD at fourchamber view showed ostium primum atrial septal defect and the mitral and tricuspid valves attaching at the same level on the interventricular septum. Atrio-ventricular valves took on a straight, bar-liked appearance when closed and constituted a “T” shape with interventricular septum. One partial AVSD case showed left ventricle-right atrium canal. All intermediate AVSD cases showed upper ventricular septal defect. There were four cases associated with mitral reflux, one associated with mitral and tricuspid reflux and one with bilateral radius absence. Conclusions “T” shape image is of great clinical value in prenatal diagnosis of fetal partial and intermediate AVSD. The coronary sinus may lead to false positive diagnosis.

Objective To investigate the clinical value of prenatal ultrasonography in diagnosing fetal aortic atresia.Methods Ultrasound images of 9 cases with fetal aortic atresia confirmed by autopsy were retrospectively analysed and summarized.Results Fetal echocardiography showed ascending aorta and aortic arch were thin in seven cases and unclear in two cases.Color Doppler flow imaging showed fetal aorta no blood connection with left ventricle and reverse blood flow in aortic arch among all 9 cases.There were 6 cases associated with hypoplastic left heart syndrome,two cases associated with ventricular septal defect and well-developed left ventricle,one case complicated with complete atrioventricular septal defect.Nine cases were detected at average gestational age (26.0 ± 2.6) weeks,minimum gestational age was only 16 weeks pregnant.Conclusions Prenatal ultrasound diagnosis of fetal aortic atresia has important clinical value.Ascending aorta and aortic arch are thin or unclear,no blood flow connection between fetal aorta and left ventricle and reverse blood flow in aortic arch are major diagnostic evidences.Color Doppler flow imaging is helpful for early diagnosis.

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of complete vascular ring. Methods Ultrasound images of 6 cases with complete vascular ring were retrospectively analysed and summarized, all cases were confirmed by autopsy after termination of pregnancy. Results Right aortic arch and left ductus arteriosus formed U shaped comlete vascular ring coursing around the trachea in 5 cases, left aortic arch and right aortic arch formed O shaped complete vascular ring in 1 case on three-vessel trachea view. Color Dopple flow imaging aided in identifying various components of the vascular ring. Conclusions Fetal echocardiography is of great clinical value in prenatal diagnosis of complete vascular ring. Three-vessel trachea view is important for screening with particular attention to the relationship of the aortic and duct arches to the trachea.