CAJ | 학술논문

目的探讨三维超声技术对胎儿四肢骨骼发育异常的诊断价值。方法 2005年12月-2009年12月间，孕14～40周到我院进行常规超声筛查的胎儿，二维超声产前超声筛查发现胎儿四肢骨骼发育有异常的留存图像，同时用三维超声的表面成像模式和透明成像模式技术对病变部位进行三维成像，对比前后两种检查方法的图像，观察畸形部位及类型。结果在38 974例胎儿中二维超声检出70例，三维超声检查检出78例，产后追踪时发现二维超声检查漏诊四肢畸形胎儿14例，漏诊病例为多指4例，多趾2例，缺趾2例，并指4例，手指姿势异常2例；三维超声检查漏诊四肢畸形胎儿6例，漏诊病例为多指2例，多趾2例，并指2例。三维超声对胎儿四肢畸形的检出率高于二维超声，主要在于提高胎儿手指、脚趾等畸形诊断的准确性。结论二维超声与三维超声对胎儿四肢长骨畸形的诊断上没有明显区别，但在胎儿手指、脚趾等细节畸形的诊断上，三维超声优于二维超声，而且三维超声图像直观，易于与孕妇沟通。
목적 탐토삼유초성기술대태인사지골격발육이상적진단개치。방법 2005년12월-2009년12월간，잉14～40주도아원진행상규초성사사적태인，이유초성산전초성사사발현태인사지골격발육유이상적류존도상，동시용삼유초성적표면성상모식화투명성상모식기술대병변부위진행삼유성상，대비전후량충검사방법적도상，관찰기형부위급류형。결과 재38 974례태인중이유초성검출70례，삼유초성검사검출78례，산후추종시발현이유초성검사루진사지기형태인14례，루진병례위다지4례，다지2례，결지2례，병지4례，수지자세이상2례；삼유초성검사루진사지기형태인6례，루진병례위다지2례，다지2례，병지2례。삼유초성대태인사지기형적검출솔고우이유초성，주요재우제고태인수지、각지등기형진단적준학성。결론 이유초성여삼유초성대태인사지장골기형적진단상몰유명현구별，단재태인수지、각지등세절기형적진단상，삼유초성우우이유초성，이차삼유초성도상직관，역우여잉부구통。
Objective To explore the diagnostic value of three-dimensional ultrasonography to fetal limb skeletal dysplasia. Methods From December 2005 to December 2009, the fetus with pregnancy of 14 to 40 weeks after routine ultrasound screening were given two dimensional prenatal ultrasound screening, and we found fetal limb skeletal growth abnormalities retained images, meanwhile we used three-dimensional ultrasound surface imaging mode and transparent imaging mode techniques, the location and types of malformations observed by these two kinds of methods were compared. Results Among the 38 974 cases, 70 cases of abnormalities detected by two-dimensional method, while 78 ones detected by three-dimensional ultrasound method, during postpartum follow-up study, 14 cases of miss diagnosis were found, including 4 cases of polydactylism, 2 cases of polydactyly, 2 cases of toe absence, 4 cases of syndactyly, and 2 cases of abnormal finger posture; while in those with three-dimensional ultrasound method, there were only 6 cases found as miss diagnosis, including polydactylism, polydactyly and syndactyly,2 cases for each. The detectable rate for fetal limb deformities of three-dimensional ultrasound was significantly higher than that of two-dimensional ultrasound method. The methods were mainly used to increase diagnostic accuracy for fetal fingers and toes deformities.Conclusions There is no obvious difference in fetal long bone deformity diagnosis between the methods of two-dimensional and three-dimensional ultrasound, but in the fetal fingers, toes and other details, the results of the three-dimensional ultrasound diagnosis is better than that of two-dimensional one. The three-dimensionul ultrasound diagnosis image is intuitive which provides convenience for communicating with pregnant women.