产前超声及胎儿磁共振对先天性食管闭锁的诊断价值  

Diagnostic value of prenatal ultrasound and MRI in congenital esophageal atresia

作　　者：唐雪珍[1] 李鸿恩 陈丹[1] 冯鑫[1] 黄育斌[1] TANG Xue-zhen;LI Hong-en;CHEN Dan;FENG Xin;HUANG Yu-bin(Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院,广东广州511400

出　　处：《中国临床医学影像杂志》2021年第1期29-32,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:提高对先天性食管闭锁(CEA)的认识,探讨产前超声及胎儿MRI对CEA的临床价值。方法:回顾性分析29例经临床证实的CEA胎儿产前超声及胎儿MRI资料。纳入29例正常胎儿作为对照组。分析CEA影像征象,比较组间羊水深度(AFD)、羊水指数(AFI)、双顶径(BPD)、头围(HC)、腹围(AC)、股骨径(FL)、脐动脉S/D差异。结果:超声发现羊水过多26例,胃泡未显示或胃泡小同时伴有羊水过多14例。胎儿MRI显示食管囊袋7例,胃泡未显示或胃泡小8例,咽部扩张1例。CEA组AFD、AFI、脐动脉S/D大于对照组,AC小于对照组,BPD、HC、FL组间无统计学差异。结论:胃泡未显示或胃泡小、羊水过多是产前超声诊断CEA的重要征象。胎儿MRI作为补充手段,能够检出颈部囊袋、咽部扩张等超声难以发现的影像征象。CEA一般不影响胎儿生长发育,但羊水过多、脐动脉S/D升高可能是导致早产与剖宫产率增加的一个重要因素。Objective:To improve the awareness of congenital esophageal atresia(CEA)and explore the clinical value of prenatal ultrasound and fetal MRI to CEA.Methods:Prenatal ultrasound and fetal MRI data of 29 cases clinically confirmed were retrospectively reviewed.Twenty-nine normal fetuses were included as the control group.The CEA imaging features were analyzed.Differences of amniotic fluid depth(AFD),amniotic fluid index(AFI),biparietal parietal diameter(BPD),head circumference(HC),abdominal circumference(AC),femoral length(FL),and umbilical artery S/D between groups were compared.Results:Ultrasound showed polyhydramnios in 26 cases,and absent fetal stomach or small fetal stomach accompanied by polyhydramnios in 14 cases.Fetal MRI showed esophageal pouch in 7 cases,absent fetal stomach or small fetal stomach in 8 cases,and distended fetal hypopharynx in 1 case.In the CEA group,AFD,AFI,and S/D were greater than the control group,and AC was smaller than the control group.There was no statistical difference between the groups of BPD,HC,and FL.Conclusion:Small fetal stomach or absent fetal stomach and polyhydramnios are important features of ultrasound diagnosis.Fetal MRI can be used as a supplementary method to detect imaging signs that are difficult to find by ultrasound such as neckpouch and hypopharyngeal dilatation.CEA generally does not affect fetal growth,but polyhydramnios and increased umbilical artery S/D may be important factors leading to premature delivery and increased cesarean delivery.

关 键 词：食管闭锁 磁共振成像 超声检查 产前 

分 类 号：R714.53[医药卫生—妇产科学] R445.2[医药卫生—临床医学]