胎儿颅内出血的产前超声表现与漏诊误诊分析  被引量:4

Prenatal Ultrasound Manifestation and Misdiagnosis Analysis of Fetal Intracranial Hemorrhage

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作  者:罗田田 张焜[1] 冉素真[1] 张晓航[1] 董虹美[1] 钟春燕 冉茜 Luo Tiantian;Zhang Kun;Ran Suzhen;Zhang Xiaohang;Dong Hongmei;Zhong Chunyan;Ran Qian(Department of Ultrasound,Chongqing Health Center for Women and Children,Chongqing 401147,China)

机构地区:[1]重庆市妇幼保健院超声科,重庆市401147

出  处:《中国超声医学杂志》2021年第12期1388-1391,共4页Chinese Journal of Ultrasound in Medicine

基  金:重庆市科卫联合医学科研项目(No.2021MSXM280);重庆市自然科学基金面上项目(No.cstc2020jcyj-msxmX0423)

摘  要:目的探讨产前超声在胎儿颅内出血的早期诊断、随访中的应用价值及漏诊、误诊病例分析。方法对我院产前超声检查诊断为颅内出血并经MRI证实的21例胎儿,以及漏诊、误诊病例各1例的超声声像图进行回顾性分析,并追踪胎儿妊娠结局。结果孕期或生后MRI证实为颅内出血的21例胎儿中超声诊断小脑出血2例,脑室周围-脑室内出血19例,其中Ⅰ级5例,Ⅱ级4例,Ⅲ级5例,Ⅳ级5例;超声表现为高回声14例,混合回声6例,无回声1例。经随访,引产16例,失访2例,出生3例,出生后均预后良好。误诊病例为1例,颅内脂肪瘤误诊为颅内Ⅳ级出血,漏诊病例为1例,胎儿颅内肿瘤合并出血,超声仅诊断颅内肿瘤,未诊断颅内出血。结论产前超声可诊断胎儿颅内出血,对其准确分级,协助临床进行产前诊断及预后咨询。但检查过程中要注意动态全面扫查、仔细观察肿块血流,必要时随访观察,避免漏诊误诊。Objective To discuss the value of pjrenatal ultrasound in early diagnosis and follow-up of fetal intracranial hemorrhage,and analyze the missed and misdiagnosis cases.Methods 21 fetus were diagnosed as intracra-nial hemorrhage by prenatal ultrasound and confirmed by MRI in our hospital,and there were 1 missed diagnosis case and 1 misdiagnosis case respectively,we retrospectively analyzed the ultrasound images of these fetus and followed up their outcomes.Results 21 cases were confirmed by MRI during pregnancy or postnatal.Among the 21 fetuses,there were 2 cases of cerebellar hemorrhage and 19 cases of periventricular-intraventricular hemorrhage.Among the 19 fetu ses,there were 5 cases of grade 1 and 4 fetusevS of grade 2.5 cases of grade 3 and 5 cases of grade 4.The ultrasonographic findings were hyperechoic in 14 cases,mixed echo in 6 cases and anechoic in 1 case.After follow-up,16 cases were terminated after prenatal diagnosis.2 cases were lost of follow up,3 cases were born with a good outcome.1 case of intracranial lipoma was misdiagnosed as intracranial W grade hemorrhage.The missed cavse was a fetal intracranial tumor combined with hemorrhage,which ultra.sound only diagnosed intracranial tumor and missed intracranial hemorrhage.Conclusions Prenatal ultrasound can be used for early diagnosis and accurate grading the fetal intracranial hemorrhage,which may be helpful in clinical prenatal diagnosis and prognosis consultation.During the examination,attention should be paid to the dynamic and comprehensive scanning,careful obvServation of the mass blood flow,and follow-up if necessary to avoid missed and misdiagnosis.

关 键 词:产前超声 胎儿 颅内出血 

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]

 

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