| 摘要: |
| 目的：分析部分胎儿颜面部畸形产前超声显示率偏低的原因及多平面连续超声扫查法在显示胎儿颜面部畸形的应用价值。方法：将9240例产前超声筛查的孕妇分为两组：常规超声筛查组4445例,对胎儿冠状切面、双眼眶横切面进行观察；多切面连续超声筛查组4795例,对胎儿颜面部进行系统扫查,侧动探头,连续扫查,加用弧形扫查法,观察胎儿鼻骨、晶状体、眼眶、牙槽突、腭、上下唇、嘴角、双耳。发现可疑畸形时加用三维成像并确定胎儿颜面部有无异常,并对两组胎儿颜面部异常检出率进行比较。结果：两组9240例胎儿产后或引产后证实胎儿颜面部畸形31例,40处畸形,颜面部畸形发生率为0.34%(31/9240),其中常规超声筛查组颜面部畸形14例(0.31%,14/4445),多切面连续超声筛查组颜面部畸形17例(0.35%,17/4795)。两组胎儿颜面部畸形发生率比较差异无统计学意义(P>0.05)。常规超声筛查组产前超声显示颜面部畸形5例(35.7%,5/14),多切面连续超声筛查组产前超声显示颜面部畸形14例(82.4%,14/17),两组胎儿颜面部畸形产前超声显示率比较差异有统计学意义(P＜0.01)。结论：胎儿颜面部畸形种类多,形成原因复杂,受胎儿姿势、孕妇腹壁厚度、羊水量多少影响,产前超声不易观察到耳部、腭部、面裂畸形,显示率偏低。颜面部畸形的最佳时机18-24周。多切面连续超声筛查观察胎儿颜面部,可较为系统观察,有助于胎儿颜面部畸形的检出。 |
| 关键词: 产前超声检查 颜面部畸形 多切面连续超声筛查 |
| DOI： |
| 投稿时间：2018-11-12修订日期：2018-11-22 |
| 基金项目: |
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| Clinical application of ultrasound diagnosis on fetal facial deformity with a systematic continuous and multi-plane approach.Li rong,Wang wenwen,Liang xinyue,Zhang feifei.Department of ultrasound of Tianjin Women and Children health center,Tianjin,300072,China. |
| Li Rong |
| (Tianjin Women''s and Children''s Health Center) |
| Abstract: |
| Objective:To analyze the causes of low prenatal ultrasonography display of partial fetal facial deformities and the application value of multi-plane continuous ultrasonography scanning in the display of fetal facial deformities.Methods:9240 pregnant women who underwent prenatal ultrasound screening were divided into two groups:4445 in the routine ultrasound screening group,and observation was made on the fetal coronal section and bilateral orbital cross section.Among the 4795 cases in the multi-planes continuous ultrasonography groups. When the suspicious deformity was found, three-dimensional imaging was used to determine whether the fetal face was abnormal,and the detection rate of the fetal face abnormality was compared between the two groups.Results:Two groups of 9240 cases of postpartum or after induced labor confirmed 31 cases of fetal facial deformity,40 deformities. The facial deformity rate was 0.34% (31/9240). And the conventional ultrasound screening set of facial malformations 14 cases (0.31%, 14/4445),multi section continuous ultrasound screening set of facial malformations of 17 cases (0.35%, 17/4795).There was no significant difference in the incidence of fetal facial malformation between the two groups (P < 0.05).Prenatal ultrasonography showed facial deformities in 5 cases (35.7%, 5/14) in the conventional ultrasound screening group, and prenatal ultrasonography showed facial deformities in 14 cases (82.4%, 14/17) in the multi-section continuous ultrasound screening group. The difference in prenatal ultrasonography showed statistically significant difference between the two groups (P < 0.01). Conclusion:There are many types of facial deformities in the fetus,and the formation reasons are complex,which are affected by the fetal posture,the abdominal wall thickness of the pregnant woman,and the amount of amniotic fluid.Prenatal ultrasound is not easy to observe the deformities of the ear,palate and facial cleft,showing a low rate.The best time for facial deformity is 18-24 weeks.Multi-section continuous ultrasonography for the observation of fetal facial can be more systematic observation,which is helpful for the detection of fetal facial malformations. |
| Key words: Prenatal ultrasonography Facial deformity Multi-plane continuous ultrasonic screening |
