妊娠后期胎儿肝静脉发育的多普勒超声研究  

Development of the Fetal Hepatic Veins by Doppler Ultrasound during Later Pregnancy

作　　者：樊慧丽[1,2] 刘树伟[1] 张英[1,3] 张忠和[1] 田路[1,3] 曹小丽 来洪建[3] 

机构地区：[1]山东大学医学院断层影像解剖学研究中心,山东济南250012 [2]菏泽市立医院超声科 [3]菏泽市立医院CT与MR室 [4]烟台市毓磺顶医院超声科

出　　处：《解剖与临床》2011年第2期103-107,共5页Anatomy and Clinics

摘　　要：目的：利用彩色多普勒超声观察妊娠后期胎儿肝静脉的发育状况，从而为肝发育异常性疾病的诊断及治疗提供依据。方法：选择临床及常规超声检查排除各种病变的正常单胎妊娠胎儿118例，孕龄26—40周；采用多功能彩色多普勒超声显像仪进行扫查，观察胎儿肝左、中、右静脉汇入下腔静脉的类型，肝静脉的内径与属支、相互夹角以及血流动力学的状态。记录相关数值并进行分析。结果：肝中静脉与肝左静脉合干后汇入下腔静脉（I型）者57例（48．3％），肝左、中、右静脉分别汇入下腔静脉（Ⅱ型）者53例（44．9％），肝中、右静脉合干或出现肝右后静脉等（Ⅲ型）者8例（6．8％）。随孕周增加，肝静脉内径增加，肝左、中、右静脉内径分别为（0．34±0．04）cm、（0．35±0．04）em、（0．36±0．05）em，与孕周有较高的相关性。可观察到的肝静脉属支l～4支不等。肝右静脉与肝中静脉之间的夹角为（56．8±14．2）°，肝中静脉与肝左静脉之间的夹角为（50．7±19．4）°，肝左静脉与肝右静脉之间的夹角为（98．4±20．3）°。肝静脉和下腔静脉血流频谱为三相，随孕周增加a／s值逐渐减小。以上各数值未见明显性别差异。结论：胎儿肝静脉发育状况与成人不同，胎儿肝静脉属支变异较大。本研究可以丰富与完善肝静脉发育影像学知识，提高肝静脉发育异常胎儿临床诊断水平。Objective：To reveal the development of the fetal hepatic veins during later pregnancy by Doppler ultrasound and provide evidence for the diagnosis and treatment of the abnormally developmental hepatic veins. Methods： 118 normal single - pregnancy fetuses of 26 to 40 weeks gestational age were selected. The fetuses were considered to be anatomically normal and developmentally appropriate by routine ultrasound examination. By multi - functional Doppler ultrasound scanning, the types of the left, middle and right hepatic veins drained into the inferior vena cava, the branches and internal diameter of the hepatic veins, the angles between the hepatic veins, and the hemodynamic state were analyzed. Results ：57 （48.3%）cases of the middle and left hepatic veins joined together before they drained into the inferior vena cava （Type I ） ; 53（44.9% ）cases in which the left, middle and right hepatic veins joined the inferior vena cava respectively （ Type Ⅱ ） ; 8 （6. 8% ） cases in which the middle and right hepatic veins joined together before they went into the inferior vena cava, and in which the right - posterior hepatic vein even appeared （ Type Ⅲ ）. The internal diameter of the hepatic veins gradually increased with the gestational age. The internal diameters of the left, middle and right hepatic veins were （ 0.34 ± 0.04） cm, （ 0.35 ± O. 04 ） cm and （0.36 ±0.05 ） cm respectively. There were high coefficient correlations between them and the gestational weeks. 1 - 4 branches of the hepatic veins could be observed. The angle between the right and middle hepatic veins was （ 56.80± 14.20 ） °, the angle between the middle and left hepatic veins was （50.70 ± 19.40） °, and the angle between the left and right hepatic veins was （ 98.40 ± 20.30） °. A three - phase blood flow spectrum could be observed in the hepatic veins and the inferior vena cava. The a/s decreased gradually with the gestations. There were no significant gender differences in the data listed abo

关 键 词：胎儿 肝静脉 发育 彩色多普勒超声 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]