胎儿宫内肠套叠的超声特征分析  

Prenatal diagnosis of intrauterine intussusception by ultrasonography

作　　者：刘爽[1] 马玉庆[1] 吴青青[1] 

机构地区：[1]首都医科大学附属北京妇产医院超声科,100026

出　　处：《中华医学超声杂志（电子版）》2017年第8期613-617,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：北京市医院管理局"登峰"计划专项经费资助(DFL20151302);首都卫生发展科研专项(首发2014-2-2113);国家卫生和计划生育委员会-国家科技支撑计划:重大出生缺陷防治技术开发及应用研究(2014BAI06B05)

摘　　要：目的探讨胎儿宫内肠套叠超声声像图特征。方法对2014年1月至2016年12月在首都医科大学附属北京妇产医院产前超声检出的5例宫内肠套叠胎儿的超声表现进行分析。结果 5例胎儿肠套叠直接超声征象为"同心圆征"、"套筒征"、"面包圈征"和"新月征";间接超声征象为肠梗阻及胎粪性腹膜炎等。产科处理及随访结果:3例剖宫产紧急终止妊娠,出生儿转小儿外科手术,手术检查均证实为宫内肠套叠,患儿术后均恢复良好。另2例胎儿产前继发胎粪性腹膜炎,自然分娩后转小儿外科行剖腹探查术,均证实均为肠套叠,两患儿并发肠闭锁,术后死亡。结论胎儿宫内肠套叠与肠梗阻、胎粪性腹膜炎及肠道闭锁密切相关,产前超声检查正确识别胎儿肠套叠特征性超声表现及其并发症,对指导产科处理和胎儿出生后手术治疗有重要作用。Objective To discuss the prenatal ultrasound manifestations of intrauterine intussusception. Methods An analysis of prenatal ultrasound findings and postnatal features was performed on five cases of fetuses with intrauterine intussusception that were identified by ultrasonography at Beijing Obstetrics and Gynecology Hospital, in the period of January 2014 to December 2016. Results The 5 fetuses with intrauterine intussusception were diagnosed based on the typical ＂target sign＂, ＂telescope sign＂, ＂doughnut sign＂ and ＂crescent-in-doughnut sign ＂in ultrasonography. Indirect and non-specificultrasonographic signs included dilatation of intestine and ascites. Three cases of emergency caesarian section were performed, and infants underwent surgeries. The intraoperative findings confirmed the prenatal diagnosis, and postoperativelythe infantsrecovered uneventfully. In another 2 cases, whichwere suspected the presence of meconium peritonitis, fetus prematurely bornvia a spontaneous vaginal delivery, and the intraoperative findings confirmed the prenatal diagnosis. However, intestinal atresia occurred, and the neonates died postoperatively. Conclusions Fetuses with intrauterine intussusceptionshad characteristic ＂target sign＂, ＂telescope sign＂, ＂doughnut sign＂ and ＂crescent-in-doughnut sign＂ in ultrasonography. Ultrasonography may be used as the first choice for prenatal diagnosis of this disease. Prenatal diagnosis of intrauterine intussusception can provide guidance for clinical obstetrical management and postnatal treatment.

关 键 词：超声检查 产前 胎儿 先天畸形 宫内肠套叠 

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]