| 摘要: |
| 目的 评价早孕期(11～13+6周)超声观察犁骨与上颌骨结合处形成的“叠线”征在胎儿腭裂筛查中的临床价值。 方法 回顾性分析经产后或引产后证实为腭裂的45例胎儿(病例组)和4500例经产后证实为正常胎儿(对照组)的早孕期(11～13+6周)颈项透明层检查的面部正中矢状面声像图,观察和记录犁骨与上颌骨结合处所形成的“叠线”征声像表现,并进行组间比较分析。 结果 45例病例组胎儿中“叠线”征缺失39例(86.67%,39/45),其中单纯继发腭硬腭裂4例(8.89%,4/45),继发腭硬腭裂合并原发腭裂35例(77.78%,35/45)； “叠线”征存在6例(13.33%,6/45),其中单纯软腭裂2例(4.44%,2/45),单纯悬雍垂裂1例(2.22%,1/45),单纯原发腭裂3例(6.67%,3/45)；4500例对照组胎儿中“叠线”征存在4469例(99.31%,4469/4500),“叠线”征缺失31例(0.69%,31/4500)。组间胎儿“叠线”征存在与否情况比较差异有统计学意义(P＜0.05)。运用“叠线”征缺失预测胎儿腭裂的敏感性、特异性、阳性预测值、阴性预测值分别是86.67%(39/45), 99.31%(4469/4500), 55.71%(39/70), 99.86%(4469/4475)。 结论 继发腭硬腭裂合并或不合并原发腭裂表现为“叠线”征缺失,单纯原发腭裂、单纯软腭裂、单纯悬雍垂裂和正常胎儿“叠线”征存在。早孕期胎儿面部正中矢状面上“叠线”征缺失在胎儿腭裂尤其是继发腭硬腭裂筛查中有重要价值。 |
| 关键词: 胎儿 腭裂 超声 早孕期 |
| DOI： |
| 投稿时间：2022-09-08修订日期：2022-09-19 |
| 基金项目:四川省卫生健康委员会科研课题(20PJ189) |
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| The Utility of the Ultrasound " Superimposed-Line" Sign in First Trimester Screening for Fetal Cleft Palate |
| Hu Lirong,Luo Yu,Feng Mengjuan |
| (Chengdu First People’s Hospital) |
| Abstract: |
| Objective: The current study evaluates the diagnostic value of screening for a fetal cleft palate by using the ultrasound-based observation of the "superimposed-line" sign appearing at the junction of the vomer and maxilla in the first trimester of pregnancy. Methods: Retrospective analyses were performed of ultrasonographic images of nuchal translucency (NT) obtained during the first trimester of pregnancy (11–13+6 weeks) from 45 fetuses with a cleft palate later confirmed following parturition or induced labor (cases) and 4500 normal fetuses confirmed after parturition (controls). Ultrasonographic features of the "superimposed-line" sign were observed and recorded, and between-group comparisons were performed. Results: The "superimposed-line" sign was absent in 39 cases (86.67%), including 4 (8.89%) with simple secondary hard palate cleft and 35 (77.78%) with secondary hard palate cleft complicated by a primary cleft palate. 6 cases showed the "superimposed-line" sign (13.33%), including 2 (4.44%) with a simple secondary soft palate cleft, 1 (2.22%) with a simple secondary bifid uvula, and 3 (6.67%) with a simple primary cleft palate. Among the 4500 controls, 4469 fetuses showed the "superimposed-line" sign (99.31%) and 31 fetuses showed an absence of the "superimposed-line" sign (0.69%). The between-group difference was significant (p<0.05). The sensitivity, specificity, positive predictive value, and negative predictive values of the "superimposed-line" sign in the first trimester of pregnancy for predicting fetal cleft palate were 86.67%(39/45), 99.31%(4469/4500), 55.71%(39/70), and 99.86%(4469/4475), respectively. Conclusion: The "superimposed-line" sign did not appear in fetuses with secondary hard palate cleft and primary cleft palate only when a secondary hard palate cleft is present. The sign appeared in normal fetuses and those with a simple primary cleft palate, simple secondary soft palate cleft, or with a simple secondary bifid uvula. Based on these results, we propose that the "superimposed-line" sign in the mid-sagittal plane of the fetal face in the first trimester of pregnancy is an important tool in screening for fetal cleft palate, especially secondary hard palate cleft. |
| Key words: Fetus, cleft palate, ultrasound,first trimester. |
