正常胎儿气管与支气管的超声观测  

Observation and measurement of trachea and bronchus in normal fetuses by prenatal ultrasonography

作　　者：尹邵丽 吴瑛[1] 刘涛[1] 熊奕[1] 林琪[1] 张玉娟[1] 刘士龙[1] 牟赛辉[1] 

机构地区：[1]暨南大学附属第二临床医学院深圳市人民医院超声科,深圳518020

出　　处：《中华超声影像学杂志》2015年第4期328-332,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨产前超声观察正常胎儿气管与支气管的方法及图像特征，测量相关参数并建立正常参考值范围。方法在胸部气管与支气管冠状切面观察970例20～39周“正常单胎胎儿的气管与支气管，依据孕周不同分为5组统计显示率：A组344例（2023周＋6），B组111例（24～27周＋6），C组160例（28～31周＋6），D组17．5例（32--35周＋6），E组180例（36～39周＋6）。并按每一孕周分组测量气管与支气管的直径及二者间的夹角。结果970例中，超声清晰显示并测量胎儿气管与支气管565例（58．2％），5组胎儿的显示率分别为53．5％、79．3％、68．1％、48．3％、55．4％。其中B、C两组高于A、D、E组（P〈0．05）。标准切面显示气管及两侧支气管呈倒“Y”字形无回声区，右支气管较粗短，走形较陡直；左支气管较细长，走形较平直，奇静脉位于右支气管起始处的前外侧。气管及左、右支气管的直径与孕周呈显著正相关（r值分别为0．869、0．663、0．647，P值均〈0．0001）。气管与支气管的夹角与孕周无显著相关性（P〉0．05）。气管与左支气管的夹角小于其与右支气管的夹角（P〈0．05）。结论在胸部气管支气管冠状切面上能清晰显示胎儿气管与支气管的整体形态，最佳观察时期为孕24～31周＋6。气管支气管直径及二者之间的夹角可为产前评估气管支气管的形态及生长发育提供有价值的参考，并有可能成为超声判定胎儿内脏方位的一种新方法。Objective To explore the methodology of observing trachea and bronchus in the normal fetuses by prenatal ultrasound and to summarize its ultrasonographic features, then to measure relevant parameters and to establish their normal reference value range. Methods Nine hundred and seventy normal fetuses from 20 to 39＋6 weeks of gestation were observed by ultrasound at the coronal section of trachea and bronchus. The subjects were classified into five groups according to gestational age to calculate demonstration rate ： group A, 20 - 23 weeks ; group t3,24 - 27 weeks ; group C, 28 - 31 weeks ; group D, 32 - 35 weeks, group E, 36 - 39 weeks. The fetuses whose trachea and bronchus were clearly shown were grouped by each gestational week to measure the diameters of trachea and left/right bronchus and the angle between them. Results There were 565 fetuses whose trachea and bronchus could be demonstrated clearly （58.2 % ）. The numbers and demonstration rates of each group were following：group A 184（53.5 %）, group B88（79.3%）,group C 109（68.1%）,group D 97（48.3%） and group E 87（55.4%）. The results of both group B and C were significantly higher than others （ P 〈0.05）. The figure of trachea and bronchus was anechoic and similar to an inverted ＇ Y＇ shape at coronal standardized views. The right bronchus was thick, short and steep,while the left was thin,long and smooth relatively. Azygos vein was located in the anterior lateral of right bronchus＇ initial segment.The diameters of trachea and left/right bronchus were significantly positive correlated to gestational age（ r = 0.869,0.663 and 0.647 respectively, P 〈0.0001）. There were no correlation between the angles of trachea and left/right bronchus and gestational age（ P〈0.05）. The angle between trachea and left bronchus was smaller than that of trachea and right bronchus （P 〈 0.05）. Conclusions It is feasible to observe fetal trachea and bronchus at the coronal view of thorax. The appropriate gestational age for ultras

关 键 词：超声检查 产前 胎儿 气管 支气管 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]