产前超声在胎儿阴茎阴囊转位中的应用价值  

Prenatal ultrasound diagnosis of penoscrotal transposition

作　　者：孔凤贝 张蒂荣[1] 石宇[1] 魏小燕[1] KONG Feng-Bei;ZHANG Di-Rong;SHI Yu(Department of Ultrasound Imaging,Peking University Shenzhen Hospital,Shenzhen,Guangdong 518036,China)

机构地区：[1]北京大学深圳医院超声影像科,广东深圳518036

出　　处：《中国妇幼保健》2022年第23期4529-4532,共4页Maternal and Child Health Care of China

基　　金：北京大学深圳医院三名工程项目(SZSM201512026)。

摘　　要：目的 探讨胎儿阴茎阴囊转位的产前超声声像图特点及应用价值。方法 回顾性分析2010年1月—2020年1月经北京大学深圳医院产前超声检查疑似阴茎阴囊转位的14例胎儿的二维与三维超声声像图特征及并发畸形,并追踪随访胎儿的妊娠结局。结果 14例产前超声疑似阴茎阴囊转位的胎儿中,8例因合并其他畸形引产,6例出生。10例经产后证实为阴茎阴囊转位,准确率为71.4%;4例误诊,误诊率为28.6%。胎儿阴茎阴囊转位共同的声像图特点表现为冠状切面显示阴囊分裂,阴茎短小位于中间;矢状面显示阴茎位于阴囊中间或下方。三维图像可直观显示阴茎位于分裂阴囊的中间或下方。其中5例阴茎阴囊转位的胎儿产前行羊水穿刺或脐血穿刺,染色体核型分析均未见异常,染色体微阵列分析(CMA)检测出1例2p11.2缺失495 kb, 17p11.2重复382 kb。4例误诊胎儿中2例为尿道下裂会阴型,1例为小阴茎,1例为正常女婴。10例阴茎阴囊转位的胎儿均合并尿道下裂,8例合并阴茎短小及下弯畸形,5例合并肛门闭锁、十二指肠闭锁等消化道畸形,5例合并脊柱裂、尾椎缺失等神经系统畸形,3例复杂心脏畸形,2例小耳畸形,1例小眼畸形,1例右肾积水,2例胎儿宫内发育迟缓。结论 产前超声诊断阴茎阴囊转位有效可行,但需慎重诊断并不断提高检查技巧以减少假阳性。Objective To study the prenatal sonography characteristics of penoscrotal transposition and clinical value.Methods 14 cases of suspected penoscrotal transposition of fetuses from January 2010 to January 2020 were included.The ultrasound findings, complications, fetal chromosome examination and clinical outcome were retrospectively summarized.Results Among the 14 suspected cases of penoscrotal transposition, 10 cases were diagnosed correctly.There were some common sonography characteristics.On axial scan, showing 2 separated scrotal sacs, and the penis was between or below the scrotum.On sagittal scan of the lower abdomen, the scrotum was located higher than the penis in position.3 D mode were showed the "tulip sign".5 of 10 fetuses underwent amniocentesis or cordocentesis.The karyotype of there chromosomes were normal.Chromosome microarray analysis(CMA) detected 1 anormal case that included deletions of chromosomes 2 p11.2 and duplication of chromosomes 17 p11.2.In the remaining four misdiagnosed cases, 2 were perineum hypospadias, 1 was microphallus, 1 was normal female fetus with the karyotype of 46-XX.All of 10 cases of penoscrotal transposition accompanied with hypospadias, 8 cases with short penis and under bending deformity, 5 cases with digestive system malformation, 5 cases with nervous system abnormalities spina bifida, lack of coccygeal vertebra,3 cases with complex cardiac anomalies, 2 cases with microtia, 1 cases with microphthalmia, 1 cases with hydronephrosis, 2 cases with intrauterine growth restriction.Conclusion Prenatal ultrasonography was effective and feasible in detecting penoscrotal transposition, but must be prudent and improving scan skills to reduce misdiagnosis.

关 键 词：产前超声 阴茎阴囊转位 并发畸形 

分 类 号：R445.1[医药卫生—影像医学与核医学]