CAJ | 학술논문

目的总结胎儿唇裂及唇腭裂二维超声及三维超声声像图特征.方法应用二维超声及三维超声多种成像模式重建法对10268例胎儿行产前唇腭部超声筛查,并与引产或产后检查结果进行对照分析,总结胎儿唇腭裂超声声像图特征.结果10268例胎儿经引产(9例)或胎儿自然分娩后(1例单胎,1例双胎)检查证实产前二维超声正确诊断唇腭裂畸形9例,三维超声正确诊断唇腭裂畸形10例.其中二维超声漏诊1例唇腭裂,三维超声诊断为Ⅲ度唇腭裂;二维及三维超声均漏诊1例Ⅰ度唇裂:二维超声无异常表现,三维超声表面成像模式显示胎儿唇红处可疑回声缺失,误诊为胎儿人中,胎儿自然分娩后证实新生儿为Ⅰ度唇裂.11例唇腭裂胎儿产前超声声像图表现:(1)单纯唇裂3例,超声声像图示一侧或双侧上唇部连续性中断,回声缺失;(2)唇腭裂合并牙槽突裂7例,腭部连续性中断,回声缺失.(3)三维超声表面成像及断层成像(TUI)模式可直观、立体显示胎儿唇裂类型,诊断唇裂3例,唇腭裂7例;骨骼成像及TUI模式显示牙槽突至鼻切迹处的上颌体不连续回声图像,旋转X轴连贯显示硬腭的连续性中断.(4)唇腭裂合并其他畸形3例,其中唇腭裂合并足外翻和眼距宽1例、心脏畸形1例,手畸形1例.结论建立在二维超声基础上的三维超声重建丰富了二维超声影像信息,二维及三维超声联合检查可提高唇裂及唇腭裂产前超声诊断准确性,减少漏误诊.
목적총결태인진렬급진악렬이유초성급삼유초성성상도특정.방법응용이유초성급삼유초성다충성상모식중건법대10268례태인행산전진악부초성사사,병여인산혹산후검사결과진행대조분석,총결태인진악렬초성성상도특정.결과10268례태인경인산(9례)혹태인자연분면후(1례단태,1례쌍태)검사증실산전이유초성정학진단진악렬기형9례,삼유초성정학진단진악렬기형10례.기중이유초성루진1례진악렬,삼유초성진단위Ⅲ도진악렬;이유급삼유초성균루진1례Ⅰ도진렬:이유초성무이상표현,삼유초성표면성상모식현시태인진홍처가의회성결실,오진위태인인중,태인자연분면후증실신생인위Ⅰ도진렬.11례진악렬태인산전초성성상도표현:(1)단순진렬3례,초성성상도시일측혹쌍측상진부련속성중단,회성결실;(2)진악렬합병아조돌렬7례,악부련속성중단,회성결실.(3)삼유초성표면성상급단층성상(TUI)모식가직관、입체현시태인진렬류형,진단진렬3례,진악렬7례;골격성상급TUI모식현시아조돌지비절적처적상합체불련속회성도상,선전X축련관현시경악적련속성중단.(4)진악렬합병기타기형3례,기중진악렬합병족외번화안거관1례、심장기형1례,수기형1례.결론건립재이유초성기출상적삼유초성중건봉부료이유초성영상신식,이유급삼유초성연합검사가제고진렬급진악렬산전초성진단준학성,감소루오진.
Objective To summarize the features of fetal cleft lip with or without cleft palate with two-dimensional(2D)and three-dimensional(3D)ultrasonography scanning.Methods Retrospective analysis of three planes of verticality of two-dimensional ultrasonography and reconstruction of three-dimensional ultrasonography of 10 268 cases of fetal lip and palate were examined in our hospital , and sonographic characteristics of fetal cleft lip and palate examination results were compared with the postpartum diagnosis or pregnancy termination.Results Nine cases of fetal cleft lip with or without cleft palate were diagnosed by 2D ultrasound while 10 cases of fetal cleft lip with or without cleft palate were diagnosed by 3D ultrasound in 10 268 cases;8 cases were unilateral,2 cases were bilateral(3 cases of cleft lip,Ⅱdegree,7 cases of cleft lip with cleft palate,Ⅲdegree).One case of Ⅲdegree cleft lip with cleft palate,cleft palate was misdiagnosed by 2D ultrasound;1 case of Ⅰdegree cleft lip was misdiagnosed by 2D ultrasound,3D ultrasound surface mode displayed suspicious vermilion echo loss , misdiagnosed as normal fetal ,cleft lip was diagnosed in newborn,which was validated by postpartum observation (9 cases after the induction of labor and 2 cases of postpartum).Ultrasonography manifestations of eleven cases of cleft lip with or without palate :(1) Two-dimensional ultrasonographic features: 3 cases of cleft lip,simple or bilateral upper lip discontinuity ,echo loss;7 cases of cleft lip and palate, alveolar process discontinuity , echo loss.( 2 ) Three-dimensional ultrasonographic features:Surface imaging and TUI model were intuitive ,stereoscopic imaging displayed cleft lip type;bone imaging and TUI mode displayed the body of maxilla from alveolar to nasal incisures discontinuity,echo loss,the X axis rotation coherence showed discontinuity of the palate in 3 cases of cleft lip and 7 cases of cleft lip and palate.(3) Three cases of cleft lip and palate combined with other organ malformations( 1 cases of wide distance between the eyes and strephexopodia;1 cases of cardiac malformation;1 cases of hand deformities ).Conclusion Three-dimensional ultrasound reconstruction based on two-dimensional ultrasound,it enriches the two-dimensional ultrasound imaging information ,application of two and three-dimensional ultrasound in the diagnosis of fetal cleft lip with or without cleft palate can improve the diagnostic accuracy and reduce missed diagnosis or misdiagnosis .