胎儿唇裂与唇腭裂产前超声诊断分析
태인진렬여진악렬산전초성진단분석
Prenatal ultrasonic diagnosis of fetal harelip and cleft lip
  • 万方数据
    中华医学超声杂志(电子版) 중화의학초성잡지(전자판)
    CHINESE JOURNAL OF MEDICAL ULTRASOUND
    2013年 4期 269-280 ,共12页

    王子干%黄婷%张楠%李丽%许春梅%赵玉%曹颖%周峰%岳静%吴洋%孔祥花%陈鹏%段芳%赵露露%杜明明

    왕자간%황정%장남%리려%허춘매%조옥%조영%주봉%악정%오양%공상화%진붕%단방%조로로%두명명

    超声检查,产前%胎儿%唇裂%腭裂 超聲檢查,產前%胎兒%脣裂%腭裂
    초성검사,산전%태인%진렬%악렬
    Ultrasonography,prenatal%Fetus%Cleft lip%Cleft palate
    目的探讨胎儿唇裂与唇腭裂产前二维及三维超声声像图特征.方法对32例唇裂与唇腭裂胎儿产前二维和三维超声不同切面声像图特征进行总结并与引产及出生后颜面部检查结果对照分析.结果32例唇裂与唇腭裂胎儿产前超声声像图示:(1)单纯唇裂6例(18.75%,6/32,双侧1例),超声表现为上唇分布有“裂隙样”或“入”字形无回声,牙槽弓形态自然、连续完整.(2)完全唇裂伴腭裂21例(65.63%,21/32,双侧5例,中央性唇腭裂1例),超声表现为上唇部及牙槽弓分布有“裂隙样”或“决堤状”无回声.(3)唇腭裂(单侧3例,双侧1例)合并一种或多种其他畸形胎儿4例[12.5%,4/32,合并心脏异常3例,露脑畸形1例,上肢或(和)手部异常3例,足部异常1例,膈疝1例,羊水过多2例],外周血清学筛查(18-三体高风险1例)及染色体核型分析诊断13-三体(47, XY/XX+13)2例,18-三体1例,无异常1例.(4)产前超声漏诊单纯腭裂1例(3.13%(1/32)),超声检查未见异常,出生后存活.(5)32例唇腭裂胎儿临床结局:终止妊娠20例(20/32),自然分娩并存活12例(12/32),产前超声与引产和产后检查诊断符合率为96.88%(31/32),漏诊率为3.13%(1/32).结论产前超声检查在胎儿唇裂、唇腭裂诊断中作用显著,一旦发现唇裂或唇腭裂应多切面扫查相互印证以免误诊;而对未发现唇腭裂的胎儿不能除外单纯腭裂或隐蔽状态下唇腭裂存在的可能性.
    목적탐토태인진렬여진악렬산전이유급삼유초성성상도특정.방법대32례진렬여진악렬태인산전이유화삼유초성불동절면성상도특정진행총결병여인산급출생후안면부검사결과대조분석.결과32례진렬여진악렬태인산전초성성상도시:(1)단순진렬6례(18.75%,6/32,쌍측1례),초성표현위상진분포유“렬극양”혹“입”자형무회성,아조궁형태자연、련속완정.(2)완전진렬반악렬21례(65.63%,21/32,쌍측5례,중앙성진악렬1례),초성표현위상진부급아조궁분포유“렬극양”혹“결제상”무회성.(3)진악렬(단측3례,쌍측1례)합병일충혹다충기타기형태인4례[12.5%,4/32,합병심장이상3례,로뇌기형1례,상지혹(화)수부이상3례,족부이상1례,격산1례,양수과다2례],외주혈청학사사(18-삼체고풍험1례)급염색체핵형분석진단13-삼체(47, XY/XX+13)2례,18-삼체1례,무이상1례.(4)산전초성루진단순악렬1례(3.13%(1/32)),초성검사미견이상,출생후존활.(5)32례진악렬태인림상결국:종지임신20례(20/32),자연분면병존활12례(12/32),산전초성여인산화산후검사진단부합솔위96.88%(31/32),루진솔위3.13%(1/32).결론산전초성검사재태인진렬、진악렬진단중작용현저,일단발현진렬혹진악렬응다절면소사상호인증이면오진;이대미발현진악렬적태인불능제외단순악렬혹은폐상태하진악렬존재적가능성.
    Objective To discuss the features of prenatal ultrasonic images of fetal cleft lips . Methods Retrospective analysis was undertaken on prenatal ultrasonic two-dimensional and three-dimensional images from 32 cases of fetal cleft lips.And these ultrasonic features were compared with autopsy findings . Results In present study,there were 6(18.75%,6/32)cases of simple cleft lips with one case of bilateral involvement.Their prenatal ultrasonic manifestations were slit-like or Y-shape anechoic area in upper lips with intact alveolar bone.There were 21 cases of complete harelip with cleft lips (65.63%,21/32) with 5 cases of bilateral involvement and 1 case of central type.The prenatal ultrasonic manifestations were slit-like or JUEDI anechoic aera in upper lips .Fetal cleft lips combined with other malformations were found in 4 cases (12.50%,4/32) with 3 unilateral involvement and 1 bilateral involvement.These coexistent malformations were 3 cardiac anomalies,1 exencephaly,3 upper limb anomalies,1 lower limb anomaly and 1 diaphragmatic hernia.In the 32 cases, there were 2 cases of polyhydramnois.One case underwent chromosomal analysis.The abnormal results were 2 cases of 13-trisomy and 1 case of 18-trisomy.One case of simple cleft lip was missed(3.13%,1/32).The ultrasonic examination was normal and the fetus survived after birth.Conclusions Prenatal ultrasonic examination plays an important role in the diagnosis of fetal harelip and cleft lip.Multiple cross-sectional scanning and comprehensive analysis was essential in order to avoid misdiagnosis.But in negative cases,the possibility of simple cleft lip still exists .
    원문보기 원문다운로드 사이트로이동
저자의 최근 논문