中华医学超声杂志（电子版）
中華醫學超聲雜誌（電子版）
중화의학초성잡지（전자판）
CHINESE JOURNAL OF MEDICAL ULTRASOUND(ELECTRONICAL VISION)
2013年
10期
31-36
,共6页
何光智%张辉%杨建恩%熊奕%吴一彬%方耿周%阳爱民%孔卫萍%王茜
何光智%張輝%楊建恩%熊奕%吳一彬%方耿週%暘愛民%孔衛萍%王茜
하광지%장휘%양건은%웅혁%오일빈%방경주%양애민%공위평%왕천
超声检查,产前%胎儿%腭裂
超聲檢查,產前%胎兒%腭裂
초성검사,산전%태인%악렬
Ultrasonography,prenatal%Fetus%Cleft palate
目的评价三维超声自由解剖成像新技术（全方位观中任选切面）在胎儿腭部显示中的应用价值。方法应用三维超声自由解剖成像技术对100例正常胎儿经下颌颜面部正中矢状切面的容积数据进行分析，在参考切面（颜面部正中矢状切面）上描画解剖线，获取横切面（经上颌、经口裂）、冠状切面、斜冠状切面（经梨状孔、经口裂、经颏下三角）以及腭的曲面平铺成像。对5例唇腭裂胎儿按照相同技术获取容积数据并进行分析。结果100例正常胎儿中91例（91.0%，91/100）成功采集到颜面部容积数据，经三维超声自由解剖成像技术对91例容积数据进行分析，不同成像切面上腭部显示结果：（1）经上颌横切面显示胎儿牙槽突弓91例（100%，91/91），声像图表现为“C”形的弓状结构；显示硬腭91例（100%，91/91），声像图表现为两侧牙槽骨间片状强回声；经口裂横切面显示软腭81例（89.0%，81/91），声像图表现为条状软组织带。（2）冠状切面显示硬腭91例（100%，91/91），声像图表现为条状强回声带，分隔口腔和鼻腔。（3）经梨状孔斜冠状切面显示硬腭91例（100%，91/91），声像图表现为短条状强回声带；经口裂斜冠状切面显示硬腭91例（100%，91/91）；经颏下三角斜冠状切面显示硬腭91例（100%，91/91），声像图均表现为条状强回声带，其后方为声影，不能显示其上方的鼻腔及鼻中隔。（4）经梨状孔斜冠状切面显示软腭81例（89.0%，81/91），显示悬雍垂25例（27.5%，25/91），声像图表现为片状软组织回声，悬雍垂为软腭下缘正中乳头状突起；经口裂斜冠状切面显示软腭81例（89.0%，81/91）；经颏下三角斜冠状切面显示软腭81例（89.0%，81/91），声像图均表现为条状软组织带，后上方为鼻咽部无回声区。（5）腭的曲面成像显示牙槽突弓91例（100%，91/91），显示硬腭91例（100%，91/91），显示软腭81例（89.0%，81/91），显示悬雍垂25例（27.5%，25/91），声像图表现为牙槽突弓呈“C”形弓状结构，硬腭呈片状骨性强回声，软腭为片状软组织低回声。在15例包含唇腭裂畸形的容积数据中，分析者能全部确认其中的5例畸形病例，并能确认腭裂累及的部位及范围。结论三维超声自由解剖成像技术易于获取二维超声难以显示的胎儿腭部横切面和冠状切面图像，并可获取继发腭的特殊斜冠状切面图像；通过追踪腭的结构画线，可获取腭的曲面平铺成像，形象直观地显示腭部全景图。此方法可简化胎儿腭的超声检测，减少对操作者技术和经验的依赖，能较快评估胎儿原发腭及继发腭的完整性，确认唇裂胎儿有无腭裂，并可明确腭裂累及的部位及范围。
目的評價三維超聲自由解剖成像新技術（全方位觀中任選切麵）在胎兒腭部顯示中的應用價值。方法應用三維超聲自由解剖成像技術對100例正常胎兒經下頜顏麵部正中矢狀切麵的容積數據進行分析，在參攷切麵（顏麵部正中矢狀切麵）上描畫解剖線，穫取橫切麵（經上頜、經口裂）、冠狀切麵、斜冠狀切麵（經梨狀孔、經口裂、經頦下三角）以及腭的麯麵平鋪成像。對5例脣腭裂胎兒按照相同技術穫取容積數據併進行分析。結果100例正常胎兒中91例（91.0%，91/100）成功採集到顏麵部容積數據，經三維超聲自由解剖成像技術對91例容積數據進行分析，不同成像切麵上腭部顯示結果：（1）經上頜橫切麵顯示胎兒牙槽突弓91例（100%，91/91），聲像圖錶現為“C”形的弓狀結構；顯示硬腭91例（100%，91/91），聲像圖錶現為兩側牙槽骨間片狀彊迴聲；經口裂橫切麵顯示軟腭81例（89.0%，81/91），聲像圖錶現為條狀軟組織帶。（2）冠狀切麵顯示硬腭91例（100%，91/91），聲像圖錶現為條狀彊迴聲帶，分隔口腔和鼻腔。（3）經梨狀孔斜冠狀切麵顯示硬腭91例（100%，91/91），聲像圖錶現為短條狀彊迴聲帶；經口裂斜冠狀切麵顯示硬腭91例（100%，91/91）；經頦下三角斜冠狀切麵顯示硬腭91例（100%，91/91），聲像圖均錶現為條狀彊迴聲帶，其後方為聲影，不能顯示其上方的鼻腔及鼻中隔。（4）經梨狀孔斜冠狀切麵顯示軟腭81例（89.0%，81/91），顯示懸雍垂25例（27.5%，25/91），聲像圖錶現為片狀軟組織迴聲，懸雍垂為軟腭下緣正中乳頭狀突起；經口裂斜冠狀切麵顯示軟腭81例（89.0%，81/91）；經頦下三角斜冠狀切麵顯示軟腭81例（89.0%，81/91），聲像圖均錶現為條狀軟組織帶，後上方為鼻嚥部無迴聲區。（5）腭的麯麵成像顯示牙槽突弓91例（100%，91/91），顯示硬腭91例（100%，91/91），顯示軟腭81例（89.0%，81/91），顯示懸雍垂25例（27.5%，25/91），聲像圖錶現為牙槽突弓呈“C”形弓狀結構，硬腭呈片狀骨性彊迴聲，軟腭為片狀軟組織低迴聲。在15例包含脣腭裂畸形的容積數據中，分析者能全部確認其中的5例畸形病例，併能確認腭裂纍及的部位及範圍。結論三維超聲自由解剖成像技術易于穫取二維超聲難以顯示的胎兒腭部橫切麵和冠狀切麵圖像，併可穫取繼髮腭的特殊斜冠狀切麵圖像；通過追蹤腭的結構畫線，可穫取腭的麯麵平鋪成像，形象直觀地顯示腭部全景圖。此方法可簡化胎兒腭的超聲檢測，減少對操作者技術和經驗的依賴，能較快評估胎兒原髮腭及繼髮腭的完整性，確認脣裂胎兒有無腭裂，併可明確腭裂纍及的部位及範圍。
목적평개삼유초성자유해부성상신기술（전방위관중임선절면）재태인악부현시중적응용개치。방법응용삼유초성자유해부성상기술대100례정상태인경하합안면부정중시상절면적용적수거진행분석，재삼고절면（안면부정중시상절면）상묘화해부선，획취횡절면（경상합、경구렬）、관상절면、사관상절면（경리상공、경구렬、경해하삼각）이급악적곡면평포성상。대5례진악렬태인안조상동기술획취용적수거병진행분석。결과100례정상태인중91례（91.0%，91/100）성공채집도안면부용적수거，경삼유초성자유해부성상기술대91례용적수거진행분석，불동성상절면상악부현시결과：（1）경상합횡절면현시태인아조돌궁91례（100%，91/91），성상도표현위“C”형적궁상결구；현시경악91례（100%，91/91），성상도표현위량측아조골간편상강회성；경구렬횡절면현시연악81례（89.0%，81/91），성상도표현위조상연조직대。（2）관상절면현시경악91례（100%，91/91），성상도표현위조상강회성대，분격구강화비강。（3）경리상공사관상절면현시경악91례（100%，91/91），성상도표현위단조상강회성대；경구렬사관상절면현시경악91례（100%，91/91）；경해하삼각사관상절면현시경악91례（100%，91/91），성상도균표현위조상강회성대，기후방위성영，불능현시기상방적비강급비중격。（4）경리상공사관상절면현시연악81례（89.0%，81/91），현시현옹수25례（27.5%，25/91），성상도표현위편상연조직회성，현옹수위연악하연정중유두상돌기；경구렬사관상절면현시연악81례（89.0%，81/91）；경해하삼각사관상절면현시연악81례（89.0%，81/91），성상도균표현위조상연조직대，후상방위비인부무회성구。（5）악적곡면성상현시아조돌궁91례（100%，91/91），현시경악91례（100%，91/91），현시연악81례（89.0%，81/91），현시현옹수25례（27.5%，25/91），성상도표현위아조돌궁정“C”형궁상결구，경악정편상골성강회성，연악위편상연조직저회성。재15례포함진악렬기형적용적수거중，분석자능전부학인기중적5례기형병례，병능학인악렬루급적부위급범위。결론삼유초성자유해부성상기술역우획취이유초성난이현시적태인악부횡절면화관상절면도상，병가획취계발악적특수사관상절면도상；통과추종악적결구화선，가획취악적곡면평포성상，형상직관지현시악부전경도。차방법가간화태인악적초성검측，감소대조작자기술화경험적의뢰，능교쾌평고태인원발악급계발악적완정성，학인진렬태인유무악렬，병가명학악렬루급적부위급범위。
Objective To evaluate the application of “OmniView”, a new three-dimensional ultrasound technology, in displaying the fetal palate. Methods The three-dimensional volume data was acquired from 100 normal fetuses, analysed by OmniView technology with the facial midsagittal plane as the starting plane. The imaging of fetal palate was obtained in axial plane (through maxilla, oral cleft), coronal plane, oblique coronal plane (through piriform aperture, oral cleft, submental triangle), and the palate′s curved plane tiled imaging by drawing the anatomical lines on referenced sagittal plane (facial midsagittal plane). The volumes of ifve fetuses with cleft lip and palate were obtained and analysed by the same technology. Results The volume dataset of 91 (91.0%, 91/100) normal fetuses were acquired successfully, and analyzed by OmniView technology, the results of 91 normal fetal palate in different plane were: (1) In axial plane through maxilla, the visualization of alveolar process bow was 91 (100%, 91/91). It was shown as“C”shaped arcuate structure, the anechoic structure of alveolar socket could be seen on the bow, and the ifrst 6 alveolar sockets were displayed clearly. The visualization number of hard palate was 91 (100%, 91/91), it was shown as hyperechoic lfake between two sides of alveolar bones. In axial plane through oral cleft, the visualization number of soft palate was 81 (89.0%, 81/91), it was shown as a strip of soft tissue echo band. (2) In coronal plane, the visualization number of hard palate was 91 (100%, 91/91), it was shown as a strip of hyperechoic band and separated the oral and nasal cavity. (3) In oblique coronal plane through piriform aperture, the visualization number of hard palate was 91 (100%, 91/91), it was shown as a short strip of hyperechoic band. In oblique coronal plane through oral cleft, the visualization number of hard palate was 91 (100%, 91/91). In oblique coronal plane through submental triangle, the visualization number of hard palate was 91 (100%, 91/91). In the above two planes, the hard palate was shown as a strip of hyperechoic band, due to acoustic shadow behind the hard palate, the nasal cavity and nasal septum above the hard palate couldn’t be displayed. (4) In oblique coronal plane through piriform aperture, the visualization number of soft palate was 81 (89.0%, 81/91). The visualization number of uvula was 25 (27.5%, 25/91). The soft palate was shown as a lfake of soft tissue echo behind the hard palate, and the uvula was shown as papillary protrusions on the edge of the soft palate in the midline. In oblique coronal plane through oral cleft, the visualization number of soft palate was 81 (89.0%, 81/91). In oblique coronal plane through submental triangle, the visualization number of soft palate was 81 (89.0%, 81/91). In the above two planes, the soft palate was shown as a strip of soft tissue echo band, the soft tissue echo of fetal tongue was in the lower front of soft palate, and the anechoic region of nasopharynx was superior behind the soft palate. (5) In the curved plane tiled imaging of palate, the visualization number of alveolar process bow (primary palate) was 91 (100%, 91/91). The visualization number of hard palate was 91 (100%, 91/91). The visualization number of soft palate was 81 (89.0%, 81/91). the visualization number of uvula was 25 (27.5%, 25/91), the planar panorama of alveolar process bow, hard palate and soft palate could be visualized intuitively, the alveolar arch and hard palate were shown as bone-like hyperecho, and the soft palate was shown as soft tissue hypoecho. In iffteen cases′volume involved cleft lip and palate, all five cases of malformations were detected through three-dimensional data analysis, the position and range of the cleft palate could also be conifrm. Abnormal fetuses were all veriifed after induction of labor. Conclusions By three-dimensional ultrasound technology-“OmniView”, the axial and coronal plane of fetal palate could be obtained easily which was dififcult by two-dimensional ultrasound, and the special oblique coronal plane of secondary palate could be displayed easily. The panorama of the palate could be visualized intuitively though curved plane tiled imaging by drawing a line tracking the structure of the palate. This technology could simplify the ultrasound examination procedure of the fetal palate, reduce the operators′skill-dependence, and quickly evaluated the integrity of the fetal primary palate and secondary palate. For the cleft lip fetus, this technology can determine whether the cleft palate exist or not, together with their position and range.
