VACTERL联合征产前超声检查技巧与思维方法  

Skills and Thinking Methods of Prenatal Ultrasound Examination in VACTERL Association

作　　者：张君[1] 钟晓红 何晓琴 练敏 钟燕秋 钟丽萍 Zhang Jun;Zhong Xiaohong;He Xiaoqin;Lian Min;Zhong Yanqiu;Zhong Liping(Department of Ultrasound,Women and Children's Hospital,School of Medicine,Xiamen University,Xiamen.Fuijian 361000,China)

机构地区：[1]厦门大学附属妇女儿童医院,厦门市妇幼保健院超声科,福建省厦门市361000

出　　处：《中国超声医学杂志》2022年第9期1036-1039,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 总结产前超声诊断VACTERL联合征的检查技巧及思维方法,提高VACTERL联合征的产前检出率,减少漏诊率。方法 厦门大学附属妇女儿童医院产前超声怀疑VACTERL联合征时,发现其中1种以上系统畸形时,运用VACTERL联合征常见畸形思维顺序法,重点仔细寻找其他系统有无畸形,同时增加非常规切面针对性的检查,并与尸解结果进行对照分析。结果 31例VACTERL联合征产前超声诊断的畸形组合及构成比:合并3种系统畸形的有21例,所占比例为67.7%(21/31),其中心脏畸形为71.4%(15/21)、肾脏异常为66.6%(14/21)、脊柱为57.1%(12/21);合并4种系统畸形9例,所占比例为29.0%(9/31),其中心脏畸形为23.8%(5/21)、肾脏异常为28.5%(6/21)、脊柱异常为33.3%(7/21)、肛门闭锁为71.4%(15/21);合并5种系统畸形1例,所占比例为0.32%(1/31),包括心脏畸形、肾脏异常、脊柱异常、肛门闭锁、肢体异常;合并6种系统畸形0例(0/31)。对比31例胎儿病理结果:合并4种畸形的胎儿中,漏诊室间隔缺损2例、气管食管瘘和(或)食管闭锁1例、肛门闭锁1例;合并5种畸形的胎儿中,漏诊室间隔缺损1例、气管食管瘘和(或)食管闭锁1例。结论 VACTERL联合征常见畸形思维顺序法和超声检查技巧对VACTERL联合征的产前诊断具有重要意义。Objective To summarize the examination skills and thinking methods of prenatal ultrasound in the diagnosis of VACTERL association, improve the prenatal detection rate of VACTERL association and reduce the rate of missed diagnosis. Methods When VACTERL association was suspected by prenatal ultrasound in our hospital, more than one system malformation was found, the method of common malformation sequence of VACTERL syndrome shall be used to carefully find out whether there were malformations in other systems, and the targeted examination of unconventional sections added, and the results were compared with autopsy results. Results Abnormal combination and composition ratio diagnosed by prenatal ultrasound in 31 cases of VACTERL association: 21 cases were combined with three kinds of systematic malformations, accounting for 67.7%(21/31), including heart malformation(71.4%, 15/21), renal abnormality(66.6%, 14/21), and spine(57.1%, 12/21). 9 cases were combined with 4 kinds of systemic malformations, accounting for 29.0%(9/31), including heart malformation(23.8%, 5/21), kidney abnormality(28.5%,6/21), spinal abnormality(33.3%,7/21) and anal atresia(71.4%,15/21). There was 1 case with 5 kinds of systemic malformations, accounting for 0.32%(1/31), including cardiac malformations, renal abnormalities, spinal abnormalities, anal atresia and limb abnormalities;there was no case with 6 kinds of systemic malformations detected(0/31). Prenatal ultrasound were compared with the pathological results of 31 fetuses: among the fetuses with 4 kinds of malformations, there were 2 cases of ventricular septal defect, 1 case of tracheoesophageal fistula and/or esophageal atresia and 1 case of anal atresia were missed diagnosed;among the fetuses with five kinds of malformations, 1 case of ventricular septal defect and 1 case of tracheoesophageal fistula and/or esophageal atresia was missed diagnosed. Conclusions The common malformation sequence method and ultrasonic examination skills of VACTERL association are of great significance for

关 键 词：VACTERL联合征 产前 超声检查 

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]