双胎反向动脉灌注序列征声像图与胎盘血管铸型的对比研究  

Control study of the ultrasonography with the placental vascular casts of the acardiac twins sequence

作　　者：陈欣林[1] 杨小红[1] 陈佩文[1] 赵胜[1] 彭巧英[2] 肖梅[3] 路小军[1] 赵蕾[3] 

机构地区：[1]湖北省妇幼保健院超声科,武汉430070 [2]湖北省妇幼保健院新生儿科,武汉430070 [3]湖北省妇幼保健院妇产科,武汉430070

出　　处：《中华超声影像学杂志》2011年第4期327-330,共4页Chinese Journal of Ultrasonography

基　　金：湖北省自然科学基金项目（2009CDZ025）

摘　　要：目的探讨双胎反向动脉灌注序列征（TRAP）的产前超声表现与分娩后胎盘血管铸型的关系。方法6例TRAP孕妇接受产前超声检查．妊娠结束后行胎盘血管铸型。结果本组TRAP Ⅳ型3例，Ⅱ型2例，Ⅰ型1例。胎盘血管铸型表现：6例无心畸胎与正常胎儿脐带血管之间均为动脉-动脉、静脉-静脉直接血管吻合，吻合血管表浅粗大．两条脐血管插入处间距离不等。6例中4洌无心畸胎脐动脉和脐静脉在胎盘段仅为一根大的脐动脉与一根大的脐静脉．2例无心畸胎脐动脉和脐静脉在胎盘段可见较多血管分支。6例泵血儿中4例死亡，2例存活。结论超声声像图与胎盘血管铸型有较好的一致性．有助于为深入研究TRAP的特殊血管吻合类型和预后提供有价值的信息。Objective To investigate the relationship between the ultrasonography diagnosis in prenatal and the postnatal placental vascular casts of the twins reversed arterial perfusion（TRAP） sequence. Methods Six cases of TRAP sequence underwent the two dimensional and color Doppler ultrasonograpby, and performed placental vascular casts after termination of pregnance. Results According to the anatomical features and ultrasonography.there were 3 cases of acardius acephalus（Ⅳ） ,2 cases of acardius anceps（ Ⅱ ） , and 1 case of acardius acormus（ Ⅰ ）. In all 6 cases, there were arterio arterial and veno-venous anastomoses at the level of the chorionic plate between the normal co-twin and the acardiac twin, these anastmosis vessels were superficial and large calibre, and the distances of the placental insertions of the umbilical cords were different.4 cases 〈0.5 cm,2 cases were 4- 5 cm. In 4 cases, the vessels entered and went out of the acardiac twin were just one large umbilical artery and one large umbilical vein. In 2 cases, the umbilical artery and umbilical vein had many vascular branches in the placenta. Out of 6 cases of the pump twin,4 cases died.and 2 cases survived. Conclusions Ultrasonography was consistent with the placental vascular casts.the contrast observing gives us new information for the further research of the special type of the vascular anastmosis and prognosis of the TRAP sequence.

关 键 词：超声检查 双胎反向动脉灌注序列征 胎盘 腐蚀铸型 

分 类 号：R445.1[医药卫生—影像医学与核医学]