| 摘要: |
| 目的：应用下颌骨弓横切面头侧偏移法依次获上牙槽突横切面、上唇斜冠状切面、鼻后三角切面，探讨该方法对孕11-13周+6天超声筛查胎儿唇腭裂的价值；方法：回顾分析2014年6月至2018年6月在云南省第一人民医院产科行NT检查的6089例胎儿，并与引产及产后检查结果进行对照分析;结果:孕11-13+6周NT筛查中均能筛查出胎儿唇腭裂且不受孕周影响；筛查出16例胎儿颜面显示异常，其中15例证实为唇腭裂，误诊1例，漏诊3例，敏感度为83.3％、特异度为99.9％、阳性预告值为93.8％、阴性预告值为99．9％。15例唇腭裂中，超声均表现为上牙槽突横切面，上唇斜冠状切面，鼻后三角切面分别显示上牙槽突，上唇，原发腭强回声线连续性中断。漏诊3例，1例Ⅱ°唇裂及1例单纯继发腭裂均于24周系统超声筛查检出，出生后随访得以证实，1例单纯软腭裂出生后发现。误诊1例在16周超声随访中发现正常，出生后得以证实。结论:超声下颌骨弓横切面头侧偏移法，是早孕期筛查严重胎儿唇腭裂的有效方法。 |
| 关键词: 胎儿 唇腭裂 早孕期 超声 |
| DOI： |
| 投稿时间：2019-03-06修订日期：2019-03-28 |
| 基金项目:云南省科技厅-昆明医科大学应用基础研究联合专项资金项目：云南省早孕期胎儿唇腭裂的超声筛查及其与IRF基因多态性的相关性研究(2017FE468(-120)) |
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| Ultrasonic diagnosis of cleft lip and palate of fetus at 11 - 13 weeks + 6 days to use application of head-to-side deviation method in transverse section of mandibular arch |
| chenchun,LIU Huanling |
| () |
| Abstract: |
| Target: The method of cranial defection in the curved transverse section of the lower jawbone is applied to get the transverse process section of upper alveolar, uper lip oblique coronal section and post-nasal triangle section successively and exploring the value of this method on screening the fetus’ cleft lip and palate.Method: By Reviewing and analyzing 6089 NT inspected cases of fetuses in the First People’s Hospital of Yunnan Province from June 2014 to June 2017 and contrasting the results between induced abortion and after birth; Result: the cleft lip and palate of fetus can be screened out during the weeks of 11-13+6 and will not be affected by the pregnant weeks; 16 cases of fetal facial abnormalities were screened out, including 15 cases of cleft lip and palate, 1 case of misdiagnosis and 3 cases of missed diagnosis，the sensitivity is 83. 3%, the specificity is 99.9%, positive predictive value is 93.8% and negative predictive value is 99.9%. Among the 15 cases, the ultrasound examination shows: In the transverse process section of upper alveolar, uper lip oblique coronal section and post-nasal triangle section, there is a continuous interruption on strong echo line of upper alveolar, uper lip and primary palatal. The missing diagnosed cases are not combined with other abnormal structure, among them, 2 missing cases were screened out by the systemic ultrasound examination in the week of 24, confirmed by follow-up visit after both, and 1 case of simple soft cleft palate was confirmed by follow-up visit after birth.1 case of misdiagnosis was found to be normal during 16-week ultrasound follow-up and confirmed after birth.Conclusion： The application of the method of cranial defection in the curved transverse section of the lower jawbone, an effective method to screen out severe fetus’ cleft lip and palate in early stage of pregnancy. |
| Key words: fetus cleft lip and palate first trimester ultrasound |
