胎儿骨骼系统发育异常的三维超声研究  

Prenatal Study of Fetal Skeletal Dysplasia with Three-dimensional Ultrasound

作　　者：谢红宁[1] 孔秋英[1] 蔡文[1] 李丽娟[1] 郭念群[1] 

机构地区：[1]中山大学附属第一医院超声科,广州市510080

出　　处：《中国超声医学杂志》2002年第3期228-232,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :采用三维超声成像方法观察胎儿骨骼系统发育异常 ,了解其三维声像特征 ,探讨三维超声的辅助诊断价值。方法 :对 15例产前常规二维超声检查怀疑有胎儿骨骼系统发育异常的病例进行三维超声检查。三维成像方法采用表面成像和最大透明成像法 ,并对扫查存入的三维数据库同时进行多平面分析。通过与产后检查结果对照 ,比较二维和三维超声检查对诊断病变部位、形态改变细节的准确性。结果 :15例胎儿骨骼系统发育异常中 ,无颅骨畸形 2例 ;脊柱侧弯 1例 ;脊椎裂 1例 ;四肢短小畸形 4例 ;上肢缺如 2例 ;前臂畸形 2例 ;手部缺指畸形 2例 ;足内翻 1例。所有病例都能够进行三维扫查并得出表面或最大透明三维立体图像。产前二维超声对病变部位和病变细节判断准确者分别是 10例 (6 6 .7%)和 8例 (5 3.3%) ;而三维超声对病变部位和病变细节判断准确者分别为 15例(10 0 %)和 13例 (86 .7%)。结论 :表面三维超声立体成像能够得出骨骼畸形的外貌特征 ,采用最大透明成像方式能够了解畸形的骨骼数量和形态改变。三维超声对胎儿骨骼系统发育异常的诊断提供了重要手段 ,是二维超声的重要补充。Objective:To analyze the prenatal three-dimensional ultrasound(3D US)features of skeletal dysplasia and to determine whether 3D US can reveal additional diagnostic information.Methods:Fifteen pregnant women suspected of having fetal skeletal dysplasia with routine prenatal two-dimensional ultrasound(2D US)scan were examined with 3D US.Volume-rendering image with surface and trans-maximum mode was used to reconstruct 3D images.And multi-plane analysis of scanned volume data was also used for diagnosis.The accuracy of 2D and 3D diagnosis for the malformation with detail was compare to pathology outcome.Results:Fifteen cases of skeletal dysplasias included absent skull (n=2),scoliosis(n=1),spinal segmentation defects(n=1),short limbs(n=4),absent up-limbs(n=2),abnormal forearms(n=2),abnormal hands(n=2)and club foot (n=1).All cases obtained 3D US scanned data and 3D image with surface or trans-maximum mode.Prenatal 2D US determined the site of anomaly in 10 cases (66.7%)and described the abnormality in detail in eight cases (53.3%),and for 3D US,they were 15 cases (100%)and 13 cases(86.7%),respectively.Conclusions:The surface characteristics of fetal skeletal dysplasias can be described by volume rendering image with surface mode,and the number and shape of the bony structure can be showed by volume rendering image with trans-maximum mode.3D US provides an important tool for diagnosing fetal skeletal dysplasia,thus 3D US can be used as an important method complementing 2D US.

关 键 词：胎儿 骨骼畸形 三维超声 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]