胎儿泌尿系统畸形产前、产后超声检查与尸体解剖结果的对比研究  

Prenatal Ultrasound Postmortem Fetal Ultrasound and Autopsy of Renal Tract Anomalies： Comparison Study

作　　者：陈秀兰[1] 李胜利[1] 姚远[1] 陈琮瑛[1] 欧阳淑媛[1] 龚博[1] 文华轩[1] 廖玉媚[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院超声科,广东省深圳市518028

出　　处：《中国超声医学杂志》2009年第3期328-331,共4页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市科技计划项目（No.200602109）

摘　　要：目的评价胎儿泌尿系统畸形产前超声诊断准确率，探讨泌尿系统畸形产前、产后超声扫查方法，探讨产后超声诊断泌尿系统畸形的可靠性。方法对产前超声检查发现单纯泌尿系统畸形或合并其它系统畸形且父母决定引产并同意尸体解剖的21例胎儿的尸体行高频超声检查并解剖，对比分析产前、产后超声检查及尸体解剖结果。结果21例中，产前超声发现泌尿系统异常19例，灵敏度为90．5％；产后高频超声检查均发现泌尿系统异常，灵敏度为100％。21例中，泌尿系统畸形共33处（除外3处输尿管畸形），产前超声准确诊断22处（66．7％），漏诊6处（18．2％），误诊5处（15．1％）。产后高频超声检查准确诊断30处（90．9％），漏诊1处（3．0％），误诊2处（6．1％）。结论产前超声发现胎儿泌尿系统畸形的灵敏度较高，但对畸形的归属能力的判断还有待进一步提高；泌尿系统畸形的胎儿尸体高频超声检查与尸体解剖结果符合率较高，在家属拒绝尸体解剖时，可作为替代尸体解剖的另一种选择。Objective To evaluate the accuracy of prenatal ultrasound （PU） diagnosis of congenital renal tract anomalies, to search ways of prenatal and postmortem fetal ultrasound （PMFU） scanning of urinary system malformations, to discuss the reliability of PMFU for urinary system malformations. Methods Twenty one fetuses , who were terminated because of congenital renal tract anomalies or multi-malformations besides renal tract anomalies on PU and whose parents also agreed to autopsy, were examined with high frequency ultrasound before autopsy. Results of PU, PMFU and autopsy were compared. Results Among twenty-one fetuses, nineteen were found to be abnormal on PU and the sensitivity was 90.5%. The sensitivity of PMFU was 100%. Thirty-three malformations were found in twenty- one fetuses. Twenty-two malformations （66.7%） were correctly detected on PU; six malformations were missed （18.2%） ; five malformations were misdiagnosed （15.1%） . Where as 30 malformations （90.9%） were detected by PMFU; one malformation was missed （3.0%） ; two malformations were misdiagnosed （6.1%） . Conclusions PU scanning is sensitive of urinary system abnormalities but still should be elevated. PMFU examination of renal tract anomalies is of high accordance with autopsy. PMFU is an excellent alternative when autopsy is refused.

关 键 词：产前超声 产后超声 尸体解剖 泌尿系统畸形 

分 类 号：R442.9[医药卫生—诊断学] R714.53[医药卫生—临床医学]