CAJ | 학술논문

目的：总结中孕期及晚孕期胎儿腭部超声声像图特征。方法选取孕21~36周产前二维超声和产后检查证实腭部声像正常的1885例胎儿（中孕组1023例，晚孕组862例）的超声图像进行分析。检查中采用经胎儿颌下、口裂、耳前连续区域显示腭冠状切面，经口裂显示腭纵切面，连续完整显示胎儿正常腭部并统计显示率。结果产前超声经胎儿颌下、口裂至耳前区域腭冠状切面扫查两组胎儿正常硬腭显示为横带状强回声，正常软腭显示为横带状低回声；中孕组、晚孕组胎儿腭部超声显示率分别为76%（777/1023）、53%（458/862）；经口裂腭纵切面扫查胎儿正常腭部显示为连续弧形带状回声；中孕组、晚孕组胎儿腭部超声显示率分别为49%（501/1023）、13%（113/862）。冠状切面与纵切面联合扫查中孕组胎儿腭部超声显示率为94%（961/1023），晚孕组胎儿腭部超声显示率为56%（483/862）。结论中孕期胎儿存在明显的下颌骨软骨间隙，经胎儿颌下、口裂、耳前区域腭冠状切面及经口裂腭纵切面扫查不受胎头屈曲位置影响，二维超声可较完整显示胎儿腭部声像，有助于检出单纯性继发腭裂。但由于成像过程依赖于操作者的技术和手法，尚不能作为常规筛查方法。
목적：총결중잉기급만잉기태인악부초성성상도특정。방법선취잉21~36주산전이유초성화산후검사증실악부성상정상적1885례태인（중잉조1023례，만잉조862례）적초성도상진행분석。검사중채용경태인합하、구렬、이전련속구역현시악관상절면，경구렬현시악종절면，련속완정현시태인정상악부병통계현시솔。결과산전초성경태인합하、구렬지이전구역악관상절면소사량조태인정상경악현시위횡대상강회성，정상연악현시위횡대상저회성；중잉조、만잉조태인악부초성현시솔분별위76%（777/1023）、53%（458/862）；경구렬악종절면소사태인정상악부현시위련속호형대상회성；중잉조、만잉조태인악부초성현시솔분별위49%（501/1023）、13%（113/862）。관상절면여종절면연합소사중잉조태인악부초성현시솔위94%（961/1023），만잉조태인악부초성현시솔위56%（483/862）。결론중잉기태인존재명현적하합골연골간극，경태인합하、구렬、이전구역악관상절면급경구렬악종절면소사불수태두굴곡위치영향，이유초성가교완정현시태인악부성상，유조우검출단순성계발악렬。단유우성상과정의뢰우조작자적기술화수법，상불능작위상규사사방법。
Objective To analyze the ultrasonographic features of fetal palate in the second and third trimester. Methods Two-dimensional ultrasound was performed in 1 885 fetuses during 21 to 36 gestational weeks of pregnancy, including 1 023 cases in 2nd trimester and 862 cases in 3nd trimester. The normal fetal palate ultrasound images were conifrmed by postnatal examination. In the ultrasound examination, fetal palate coronary plane was scanned through submandibular region, oral ifssure and prootic region;longitudinal plane was scanned through oral ifssure. The detection rate of completely and continuously displayed fetal palate was calculated. Results In prenatal ultrasonography, the normal fetal hard palate was shown as a bright band and the normal soft palate as a hypoechoic band in coronary section through fetal submandibular region, oral ifssure and prootic region. The detection rate was 76%(777/1 023)in 2nd trimester group and 53%(458/862) in 3rd trimester group. The normal fetal palate was shown as continuous camber echogenic band in longitudinal plane through oral ifssure. The detection rate was 49%(501/1 023) in 2nd trimester group and 13%(113/862) in 3rd trimester group. The detection rate was 94%(961/1 023) in 2nd trimester group and 56%(483/862) in 3rd trimester group by the combination of two scanning approaches. Conclusions There is usually an obvious gap between mandible gristles in 2nd trimester fetus. Fetal palate is accessible regardless of fetal head position by coronary scanning through submandibular region, oral ifssure and prootic region and longitudinal scanning through oral ifssure. These planes could display fetal palate well, and might be useful in detecting isolated secondary cleft palate. But these scanning approaches and planes might not suitable for routine screening due to operator dependence.