早孕期胎儿腭裂的产前超声诊断及漏诊原因分析  

Analysis of Prenatal Ultrasound Diagnosis and Missed Diagnosis of Fetal Cleft Palate in Early Pregnancy

作　　者：顾莉莉[1] 姜凡[1] 解翔[1] 罗平[1] 谭捷[1] 刘剑锋 张丁 Gu Lili;Jiang Fan;Xie Xiang;Luo Ping;Tan Jie;Liu Jianfeng;Zhang Ding(Department of Ultrasound,the Second Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院超声诊断科,合肥市230601

出　　处：《中国超声医学杂志》2020年第8期758-760,共3页Chinese Journal of Ultrasound in Medicine

基　　金：安徽省公益性研究联动项目(No.1704f0804028)。

摘　　要：目的探讨早孕期胎儿腭裂的声像图特征及漏诊原因。方法回顾性分析10例早孕期超声可疑腭裂的胎儿声像图,与产后及中孕早期声像图进行对照;并对早孕期漏诊的12例胎儿腭裂声像图分析,总结漏诊原因。结果早孕期可疑腭裂10例经产后病理证实,其中左侧腭裂3例、双侧腭裂4例、正中腭裂3例。腭裂早孕期声像图表现:(1)鼻后三角切面显示下方线状强回声连续性中断或缺失;(2)双侧腭裂矢状切面可见颌骨前突;(3)正中腭裂常合并全前脑。早孕期漏诊腭裂12例,其中左侧腭裂4例、双侧腭裂5例、右侧腭裂3例,均于中孕期诊断。腭裂早孕期检出率为45.5%(10/22)。漏诊原因主要为切面不标准及经验不足。结论早孕期对胎儿鼻后三角切面的仔细观察有助于腭裂的早期诊断。Objective To investigate the prenatal sonographic features and causes of missed diagnosis of fetal cleft palate in early pregnancy.Methods Ultrasound sonograms of 10 fetuses with cleft palate who were suspected by ultrasound in early pregnancy were retrospectively analyzed and compared with the results of postpartum and middle pregnancy sonograms.The data of 12 cases with cleft palate missed in early pregnancy was analyzed and the causes of missed diagnosis were summarized.Results Compared with postpartum pathology,10 cases with cleft palate were confirmed,including 3 cases of left cleft palate,4 cases of bilateral cleft palate and 3 cases of median cleft palate.The sonographic features of cleft palate during early pregnancy were as follows.(1)Ultrasound image showed continuous interruption or absence of the inferior linear strong echo in retronasal triangle,(2)Maxillary protrusion were showed in the bilateral cleft palate,(3)The median cleft palate was often complicated with holoprosencephaly.In early pregnancy,12 cases of cleft palate were missed,including 4 cases of left cleft palate,5 cases of bilateral cleft palate and 3 cases of right cleft palate.All of them were diagnosed in second trimester.The detection rate of cleft palate during early pregnancy was 45.5%(10/22).The main reasons for missed diagnosis were non-standard view and lack of experience.Conclusions Careful observation of fetal retronasal triangle during early pregnancy is helpful to the early diagnosis of cleft palate.

关 键 词：超声诊断 早孕期 腭裂 

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