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1、實時三維超聲對胎兒體表先天性畸形的診斷價值【摘要】目的:研究胎兒體表畸形的實時三維超聲表現(xiàn)及其診斷價值。方法:對46例胎兒體表畸形的二維超聲及實時三維超聲表現(xiàn)進行回顧性分析,并與引產(chǎn)后或產(chǎn)后觀察結(jié)果比較分析,計算兩者符合率。結(jié)果:二維超聲診斷符合率為76.1%(35/46),實時三維超聲診斷符合率為95.7%(44/46)。胎兒體表畸形中以中樞神經(jīng)系統(tǒng)畸形及顱骨發(fā)育異常、顏面部畸形、前腹壁缺陷和四肢異常最常見。結(jié)論:實時三維超聲在胎兒體表畸形檢查中較單獨使用二維超聲可以提高畸形檢出效果,并可取得直觀的圖片及動態(tài)視頻圖像,在胎兒體表畸形的產(chǎn)前診斷上具有較高應(yīng)用價值?!?/p>
2、關(guān)鍵詞】實時三維超聲;體表;先天性畸形;胎兒 Diagnosticvalueofreal-timethree-dimensionalultrasoundinfetalsurfacecongenitalabnormalitiesTANGXi,SONGSu-yun,WANGFeng-hu(DepartmentofUltrasound,theFirstPeople′sHospitalofHuaihuaCity,Huaihua418000,China)Abstract:ObjectiveToevaluatetheperformanceofthefetalsurf
3、acecongenitalabnormalitiesandtheirdiagnosticvaluesbyreal-timethree-dimensionalultrasound.MethodThetwo-dimensionalultrasoundandreal-timethree-dimensionalultrasoundperformancein46caseswereanalyzedwitharetrospectivemethod.Allcaseswereconfirmedafterabortionordelivery,theaccuracywascountedi
4、ntwomethods.ResultsTheaccuratediagnosisratsoftwo-dimensionalandreal-timethree-dimensionalultrasoundindiagnosingfetalsurfacecongenitalabnormalitieswere76.1%(35/46),95.7%(44/46),respectively.Dysmorphosisofthefetalcentralnervoussystemandtheskull,thefacialmalformation,exomphalosandabdomina
5、lfissure,abnormaloflimbsweremostcommoncaseofthesurfacecongenitalabnormalities.ConclusionReal-timethree-dimensionalultrasoundismorereliableandcomprehensivethanusingtwo-dimensionalultrasoundonly,andalsocanbeseenasintuitionalphotographorthevideo.Soithasgoodpracticalvalueofprenataldiagnosi
6、sinfetalsurfacecongenitalabnormalities.KeyWords:Real-timethree-dimensionalultrasound;Surface;Congenitalabnormalities;Fetus體表畸形是一組以病變累及胎兒表面,在出生或引產(chǎn)后能直接被肉眼觀察到的畸形。這類畸形表現(xiàn)直觀,孕婦及家屬心理壓力大。實時三維超聲作為一種時間-空間復(fù)合型成像,在胎兒體表畸形的超聲診斷中已有應(yīng)用[1-3]。本文回顧性研究46例經(jīng)過引產(chǎn)或產(chǎn)后觀察確診的胎兒體表畸形的實時三維超聲表現(xiàn),以提高其超聲診斷率。1資料與方法1.1研究對象:本
7、文收集我院2007年10月~2009年3月行實時三維彩超檢查的孕婦共46例,年齡21~38歲,平均(26.4±3.6)歲;孕齡12~41周,平均(25.6±4.2)周。所有胎兒經(jīng)引產(chǎn)或產(chǎn)后隨訪證實。1.2儀器和方法:采用PhilipsHD11XE實時三維彩色多普勒診斷儀,使用V6-2容積探頭,頻率為2~5MHz,MI0.6~1.2?;颊呷∑脚P位探查,必要時可取左側(cè)臥位或右側(cè)臥位。首先使用二維超聲進行胎兒畸形的常規(guī)篩查,然后對每位胎兒行顏面部實時三維成像,使用表面成像模式,適當調(diào)整儀器增益及閾值等指標,清晰地顯示觀察的部位。對二維篩查中懷疑非顏面部體表畸形者針對相