孕早中期胎儿前腹壁膨出物的超声诊断与鉴别诊断  

Ultrasound diagnosis and differential diagnosis of fetal anterior abdominal wall bulges in early and midpregnancy

作　　者：邱璇 付万袭 任贺[1] 朱海燕[2] 郝云菲 张云山 QIU Xuan;FU Wan-xi;REN He(Department of Ultrasound Diagnosis,The Sixth Medical Center of Chinese PLA General Hospital,Beijing 100048,China;不详)

机构地区：[1]解放军总医院第六医学中心超声诊断科,北京100048 [2]解放军总医院第六医学中心妇产科产前诊断中心,北京100048

出　　处：《中国医学装备》2022年第11期116-120,共5页China Medical Equipment

摘　　要：目的:分析胎儿前腹壁膨出物的二维及三维超声特征,探讨其超声诊断与鉴别诊断的临床价值。方法:选取医院收治的87例经产前彩色多普勒超声筛查出胎儿前腹壁膨出物的孕妇,分析其临床资料和超声图像,比较生理性中肠疝与脐膨出、腹裂之间在膨出物出现时间和大小的差异,以及转归情况。结果:87例孕妇中超声筛查出生理性中肠疝38例(占43.60%),脐疝1例(占1.15%),脐膨出40例(占45.98%),腹裂8例(占9.20%),且均经随访和引产证实,诊断符合率100.00%。38例生理性中肠疝均在孕13+6周前消失;40例(45胎)脐膨出中合并其他结构异常30胎(占66.67%),合并染色体异常6例(占15.00%);8例腹裂中合并其他结构异常7例(占87.50%);脐疝合并其他结构异常1例。生理性中肠疝、脐疝和腹裂均无染色体异常,生理性中肠疝与脐膨出、腹裂之间在膨出物出现时间和大小比较,差异有统计学意义(F=21.207,F=24.748;P<0.05)。结论:二维彩色多普勒超声结合三维超声能提高胎儿前腹壁膨出物的检出率及鉴别诊断,正确区分生理性和病理性膨出,其结合实验室检查和是否合并其他结构异常,可减少孕妇盲目终止妊娠,同时也为临床决策提供选择。Objective:To analyze the characteristics of two-dimensional(2D)and three-dimensional(3D)ultrasound of fetal anterior abdominal wall bulges,and explore the clinical value of ultrasound diagnosis and differential diagnosis of that.Methods:87 pregnant women whose fetuses with anterior abdominal wall bulges were screened by prenatal color Doppler ultrasonography were selected as the research objects.The clinical data and ultrasonographic images were retrospectively analyzed so as to compare the differences of occurring times and sizes of bulges among physiologic midgut hernia and acromphalus,gastroschisis,as well as termination condition.Results:In 87 pregnant women,ultrasound confirmed 38 cases were physiologic midgut hernia(43.60%),and 1 case was umbilical hernia(1.15%),and 40 cases were acromphalus(45.98%)and 8 cases were gastroschisis(9.20%).The results of follow-up and induced labor verified that the diagnostic consistency of that was 100.0%.The physiologic midgut hernia of 38 cases disappeared before pregnant 13+6 weeks.In 40 cases(45 fetuses)with acromphalus,and 30 fetuses(66.67%)combined with other abnormal structures,and 6 cases(15.00%)combined with abnormal chromosome.Seven cases(87.50%)combined with other abnormal structure in 8 cases with gastroschisis,and 1 case with umbilical hernia combined with other abnormal structure.Physiologic midgut hernia,umbilical hernia and gastroschisis did not exist abnormal chromosome.The differences of occurring time and size of bulges among physiologic midgut hernia,acromphalus and gastroschisis were significant(F=21.207,F=24.748,P<0.05).Conclusions:2D color Doppler ultrasonography combined with 3D ultrasound can improve the detection rate and differential diagnosis ability of fetal anterior abdominal wall bulges,which can correctly distinguish physiological and pathological bulges.It can reduce blind termination of pregnancy of pregnant women and provide options for clinical decision making after combined with laboratory tests and the presence of other structural abnorma

关 键 词：胎儿超声 前腹壁膨出物 生理性中肠疝 脐膨出 腹裂 

分 类 号：R445.1[医药卫生—影像医学与核医学]