Investigation of the reasons and the diagnosis of fetal right atrial enlargement

ZHANG Ying; WANG Yu

doi:10.7504/fk2016050119

Abstract：Objective To explore the reasons of fetal right atrial enlargement and to propose a proper diagnostic method.Methods Two hundred and twenty-five cases of fetal right atrial enlargement diagnosed prenatally were retrospectively reviewed.Transverse scans combined with color Doppler were used to acquire four chamber view,left and right ventricular outflow tract views,three vessel view,and three-vessel-trachea view.In addition,sagittal scans with color Doppler were used to get vena cava long axis view,aortic arch view,and ductal arch view.Sequential segmental analysis was used to exclude fetal congenital heart disease.Results In total,139 cases (61.8％) of physiological right atrial enlargement,11 cases (4.9％) of Ebstein's anomaly,21 cases (9.3％) of congenital heart disease (CHD) associated with right atrial volume overload,41 cases (18.2％) of CHD associated with right heart pressure overload,and 11 cases (4.9％) of idiopathic dilation of the right atrium were correctly diagnosed in the current study.Enlargement of right atrium in neonates were found in two cases (0.9％) who were prenatally diagnosed as physiological right atrial enlargement.Conclusions Sonographers should look into the nature of the phenomenon during examination.Secondary changes caused by cardiac anomalies should be considered when asymmetric chambers are identified.Sequential segmental analysis should be used in the diagnosis of fetal CHD while fetal cardiac hemodynamics changes should serve as the main clue during the exam ination.