胎儿肾盂扩张相关疾病的三维超声诊断研究  

Research of three dimensional ultrasound diagnosis of fetal hydronephrosis related diseases

作　　者：安园园[1] 王莉[1] 姚苓[1] 马玉庆[1] 张铁娟[1] 吴青青[1] AN Yuan-yuan;WANG Li;YAO Ling;MA Yu-qing;ZHANG Tie-juan;WU Qing-qing(Department of Ultrasonography,Bering Obstetrics and Gynecology Hospital,Capital Medical University, Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院超声科,北京100026

出　　处：《中国临床医学影像杂志》2019年第1期39-41,共3页Journal of China Clinic Medical Imaging

基　　金：国家重点研发计划(项目编号:2016YFC1000104);北京市医院管理局"登峰"计划专项经费资助(DFL20151302)

摘　　要：目的:探讨三维容积超声对胎儿肾盂扩张相关疾病的诊断价值。方法:选取于本院产检并发现胎儿肾盂扩张的孕妇85例,应用三维容积超声测量肾脏体积,并计算肾实质比率(肾脏总体积-肾积水体积)/肾脏总体积;同时按照SFU(美国胎儿泌尿外科协会)分级方法对胎儿肾积水进行分级。随访患儿预后情况,分析肾脏实质比率及SFU分级与预后的关系。结果:85例胎儿共170只肾脏,其中122只肾脏被诊断肾盂扩张,双侧肾盂扩张37例,单侧肾盂扩张48例(右侧15例,左侧33例)。所有肾脏中,SFU分级0级29只,1级21只,2级58只,3级35只,4级27只。其中3例患者选择终止妊娠。根据随访结局分为3组,出生后手术者14例,出生后需定期复查者(有可能远期手术)34例,出生后缓解者(肾盂宽度达1.0 cm以下)34例。不同结局者肾实质容积比率有明显的统计学差异(P=0.001)。结论:三维容积超声测量肾实质比率结合SFU分级对产前诊断与咨询可提供一定帮助。Objective:To evaluate the diagnostic value of three-dimensional volume ultrasound in fetal hydronephrosis re- lated diseases.Method:85pregnant women with fetal hydronephrosis were enrolled in this study.Three-dimensional volume ultrasound was used to measure the volume of kidney and caleulate the ratio of renal parenehyma (the total volume of kidney -the hydronephrosis volume)/the total volume of kidney.Meanwhile,the fetal hydronephrosis was graded according to the Soei- ety for Fetal Urology (SFU)grading system.The prognosis of children was followed up.And the relationship between renal parenchymal ratio,SFU classifieation and prognosis was analyzed.Result:This study was included 170kidneys in 85fetuses. There were 122eases diagnosed with renal pyeleetasis,37eases diagnosed with bilateral renal pelvis dilatation,and 48eases diagnosed with unilateral hydronephrosis (15eases of right,33cases of left).Aeeording to SFU grading system,there were 29 kidneys in grade 0,21kidneys in grade 1,58kidneys in grade 2,35kidneys in grade 3and 27kidneys in grade 4,respectively.Three patients ehose to terminate pregnancy.Aecording to the follow-up outcomes,all patients were divided into three groups:14cases for postnatal surgery,34eases for postnatal periodic review(possibly later surgery),34cases for postna- tal remission(the renal pelvis width was less than 1.0cm).There was a significant differenee in renal parenehymal ratio among different groups (P=0.001).Conclusion:Three-dimensional volume ultrasound eombined with SFU classification could provide some helpful information of fetal hydronephrosis related diseases in prenatal diagnosis and counseling.

关 键 词：肾盂 肾疾病 胎儿疾病 超声检查 产前 

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