食管闭锁的产前超声诊断  

Prenatal Ultrasonographic Diagnosis of Esophageal Atresia

作　　者：张忠路[1] 段仰灿[1] 王聪[1] 范东晨[1] 安霞[1] 王少春[1] Zhang Zhonglu;Duan Yangcan;Wang Cong;Fan Dongchen;An Xia;Wang Shaochun(Department of Medical Ultrasound,Affiliated Hospital of Jining Medical College,Jining,Shandong 272029,China)

机构地区：[1]济宁医学院附属医院超声科

出　　处：《中国超声医学杂志》2019年第10期922-925,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探索食管闭锁的产前超声检查技术及声像图表现。方法选取34例疑似食管闭锁的胎儿采用声束经胸骨旁长轴或(和)经主动脉弓旁长轴纵切及连续横切扫查食管、气管,在标准切面上观察上述结构,详细记录食管闭锁的超声表现。并与产后手术病理或尸检结果对照。结果经胸骨旁长轴或(和)经主动脉弓旁长轴标准纵切面及连续横切面扫查可观察食管、气管全貌,评价食管闭锁的严重程度;胎儿食管闭锁的特征性超声征象为:闭锁段食管不显示,闭锁段上方食管软组织增厚,管腔内线条状积液,部分胎儿吞咽时呈囊袋状扩张;合并食管气管瘘时,闭锁段下方食管充盈机会增多,常常伴随近闭锁段食管狭窄;无食管气管瘘时,闭锁段下方食管始终不充盈。结论胎儿食管、气管的标准切面在诊断食管闭锁、评价其严重程度时具有较高的应用价值。胎儿的食管闭锁具有特征性超声表现。Objective To explore the methodology and ultrasonographic features of esophageal atresia by prenatal ultrasound.Methods 34 fetuses with suspected esophageal atresia were prenatally diagnosed by ultrasound,whose esophagus and trachea were continuously scaned through longitudinal section of parasternal or/and para-aortic axis and transverse section.Ultrasound appearances of esophageal atresia were detailed recorded and confirmed by autopsy or postnatal examination.Results A complete picture of esophagus and trachea can be obtained through longitudinal section of parasternal or/and para-aortic axis and transverse section,while the severity of the disease can be valued.Classic acoustic properties of esophageal atresia are:atresic segment of esophagus not shown;proximal esophagus with soft tissue thickening and linear effusion in the tube;upper esophageal pouch when swallowed;the increased opportunity of effusion in the distal esophagus in the presence of the tracheoesophageal fistula,while never effusion in the absence of the tracheoesophageal fistula.Conclusions The standard sections of esophagus and trachea may be of important value in the prenatal diagnosis and the severity of esophageal atresia.Fetal esophageal atresia has the characteristic acoustic properties.

关 键 词：超声检查 产前 食管闭锁 

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]