三维超声诊断胎儿食管闭锁的价值  

Three-dimension Ultrasonography in Diagnosing Fetal Esophageal Atresia

作　　者：刘雨函[1] 蔡爱露[1] 姜红霞[2] 韩冰[1] 王冰[1] 李婧宇[1] 赵一理[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,沈阳市110004 [2]四平市中心医院超声科

出　　处：《中国超声医学杂志》2011年第3期263-266,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家科技支撑计划资助(No.2006BA105A04)

摘　　要：目的探讨三维超声诊断胎儿食管闭锁(EA)系统化的途径,为产前诊断EA探索直接、可靠的依据。方法对22例产前超声怀疑食管闭锁的胎儿进行系统的、多切面的超声扫查,包括颈部和纵隔的冠状切面与矢状切面,详细观察食管超声图像特征,扫查时间20～30 min,同时采集三维容积数据。结果 22例怀疑食管闭锁的胎儿中11例产前超声显示了食管囊袋,9例证实为食管闭锁,2例失访。11例没有显示食管囊袋的胎儿,产后证实为正常新生儿。最早显示食管囊袋的时间为26孕周。结论多切面法扫查胎儿颈部和纵隔探测食管囊袋有助于提高产前超声对食管闭锁的检出率,通过三维超声成像技术后处理功能观察食管囊袋能为产前诊断食管闭锁提供更多信息。Objective To find a new three dimension（3D） ultrasonographic approach for prenatal diagnosis of esophageal atresia （EA）. Methods A systematic multiplanar ultrasonographic scanning of the fetal upper body was performed in order to demonstrate an esophageal pouch in 22 fetuses, including two image planes of the neck and upper chest：coronal and sagittal views in the cephalic direction. The scan time was 20 30 min. Results 22 pregnant patients underwent prenatal examinations due to polyhydramnios and/or absent or small stomach. In 11 fetuses an esophageal pouch was demonstrated at ultrasonography in utero, thus a definitive diagnosis of EA was obtained. 9 fetuses were confirmed with EA postpartum and 2 cases were lost. Among 11 fetuses an esophageal pouch was not demonstrated and all proved to be normal neonates. The earliest gestational age of pouch visualization was at 26 weeks. Conclusions Our two-sectional view of the neck and upper chest is useful for in utero detection of esophageal pouch that may enhance the prenatal diagnosis of EA. 3D ultrasound with postprocessing to disclose virtual planes not visible on 2D ultrasonography facilitated the correct diagnosis,to acquire a 10s volume set that demonstrates the location and extent of the EA pouch.

关 键 词：三维超声 产前 食管闭锁 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]