先天性肛门闭锁的产前超声影像分析  

Analysis on the Prenatal Ultrasonic Imaging in Fetal Anal Atresia

作　　者：刘云[1] 栗河舟[1] 林杉[1] 王新霞[1] 王铭[1] 陈琦[2] 李战飞[3] 

机构地区：[1]郑州大学第三附属医院超声科,郑州市450052 [2]郑州大学第三附属医院小儿外科,郑州市450052 [3]郑州大学第三附属医院产科,郑州市450052

出　　处：《中国超声医学杂志》2014年第4期353-356,共4页Chinese Journal of Ultrasound in Medicine

基　　金：河南省卫生厅科技攻关项目(No.201003061)

摘　　要：目的探讨胎儿肛门闭锁的超声影像表现及其对诊断的影响。方法回顾性分析49例肛门闭锁患儿的产前超声资料。结果肛门闭锁的超声表现可分为4型:A型:结肠持续扩张或渐进性,伴或不伴肠腔内密集点状强回声;B型:结肠一过性扩张、囊肿样扩张、全腹腔肠管扩张等;C型:结肠未充盈;D型:结肠可见充盈,但不扩张。49例患儿产前检出11例,漏诊38例。检出组和未检出组比较,受检孕周、受检医师、检查方法差异均有统计学意义。结论肛门闭锁产前超声影像表现形式多样,未见结肠扩张不能排除肛门闭锁,了解非典型图像,动态系统观察肠管变化和会阴部肛门检查可以减少漏诊。Objective To investigate the ultrasonographic features and how the images impact the diagnostic of imperforate anus. Methods The ultrasonographic features of 49 patients with anal atresia were retrospectively ana- lyzed. Results The ultrasonographic images of Anal atresia can be divided into four types： Type A： typical colon ex- pansion, with or without dense point within the lumen of strong echo. Type B： colons atypical expansion, e. g. transient expansion,expansion like cyst etc. Type C：the colons were not displayed. Type D： colons were visible, but did not ex- pand. All the cases, 11 of them were diagnosis,but 38 cases were misdiagnosis. Comparing detection group with diag- nosis group, the difference was statistically significanty including gestational weeks, physician, Checking method, diges- tive system abnormalities, combined with fistula. Conclusions The prenatal ultrasound imagings about anal atresia were diversity. No typical dilatation of the colon eound not exclude anal atresia. Understanding of atypical image, the dynamic detailed observation about bowel changes and anal examination would reduce the rate of the misdiagnosis.

关 键 词：产前 超声影像 漏诊 先天性肛门闭锁 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.5[医药卫生—诊断学]