肠系膜上动脉走行异常在胎儿肠旋转不良伴中肠扭转中的超声诊断价值  

Assessment of Superior Mesenteric Artery Abnormal Course Detected by Prenatal Ultrasound in Diagnosing of Fetal Volvulus in Intestinal Malrotation

作　　者：李娜[1] 苏建强 陈桂红[1] 张燕宏[1] 孙聪欣[1] 张晓云[1] 赵伟 Li Na;Su Jianqiang;Chen Guihong;Zhang Yanhong;Sun Congxin;Zhang Xiaoyun;Zhao Wei(Department of Ultrasound,the Fourth Hospital of Shijiazhuang City,Shijiazhuang,Hebei 050011,China)

机构地区：[1]石家庄市第四医院超声科,石家庄市050011

出　　处：《中国超声医学杂志》2021年第11期1269-1272,共4页Chinese Journal of Ultrasound in Medicine

基　　金：石家庄市2019年度河北省医学科学研究重点课题计划(No.20191440)。

摘　　要：目的探讨超声检查胎儿肠系膜上动脉(SMA)走行异常在诊断胎儿肠旋转不良伴中肠扭转(VIM)中的价值。方法回顾性分析5 000例健康胎儿中晚孕腹部超声高分辨率血流成像(HD-Flow)图像,分析SMA走行特征,同时回顾性比较分析6例VIM胎儿SMA的血流显像特征及临床数据,并追踪其预后。筛查时应用低速HD-Flow技术显示胎儿SMA,观察SMA走行,定义在SMA与腹主动脉矢状切面,SMA主干不能连续自然在同一切面显示,中远段扭曲变形为走行异常。结果 HD-Flow对健康胎儿组肠系膜上动脉正常走行显示率为97%,孕晚期较孕中期SMA显示成功率降低(P<0.05)。健康组SMA自腹主动脉前壁以锐角发出后向下走行,矢状切面显示SMA形似"垂柳状",主干可连续在同一切面显示,VIM组SMA走行均异常。结论 HD-Flow成像技术可以直观地显示中晚孕期胎儿SMA走行,显示率高。胎儿SMA走行异常对VIM的诊断和预后判断具有一定价值。Objective To investigate the value of superior mesenteric artery abnormal course by prenatal ultrasound in the diagnosis of fetal volvulus in intestinal malrotation(VIM). Methods High resolution blood flow imaging(HD-Flow)images of 5 000 healthy fetuses in middle and late pregnancy were retrospectively analyzed, and the course characteristics of SMA were analyzed. Meanwhile, flow imaging features and clinical data of 6 VIM fetal SMA were analyzed retrospectively, then the prognosis was tracked. Fetal SMA was detected by low-speed HD-flow imaging during screening, and the SMA course was observed. Abnormal course is defined as that in SMA and abdominal aorta sagittal section, the SMA trunk cannot be displayed in the same section continuously and naturally, and the middle and distal is distortion. Results The demonstration rate of normal course of superior mesenteric artery in HD-Flow was 97% in healthy fetal group, and the demonstration rate of SMA was lower in the third trimester than in the second trimester(P<0.05). In healthy group, the SMA come down from the anterior wall of the abdominal aorta at an acute Angle, the sagittal plane shows a "weeping willow shaped" SMA, the trunk of SMA can be continuously displayed on the same section. All the SMA courses were abnormal in VIM group. Conclusions HD-Flow imaging technology can visually show the SMA course of fetuses in mid-to late pregnancy, and the demonstration rate is high. Abnormal fetal SMA course has a certain value for the diagnosis and prognosis of VIM.

关 键 词：产前超声 胎儿 肠旋转不良伴中肠扭转 肠系膜上动脉 腹主动脉 

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]