黏膜下腭裂的产前超声诊断  

Prenatal ultrasonic diagnosis of submucosal cleft palate

作　　者：王聪[1] 宁晓飞[2] 段仰灿[1] 毛森[1] 刘阿庆[1] 王少春[1] 张忠路[1] Wang Cong;Ning Xiaofei;Duan Yangcan;Mao Sen;Liu Aqing;Wang Shaochun;Zhang Zhonglu(Department of Ultrasound,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Gastrointestinal Surgery,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院超声科,济宁272029 [2]济宁医学院附属医院胃肠外科,济宁272029

出　　处：《中华超声影像学杂志》2022年第11期984-988,共5页Chinese Journal of Ultrasonography

基　　金：济宁市重点研发计划项目(2019SMNS004)。

摘　　要：目的:总结黏膜下腭裂的二维超声表现,探讨产前超声诊断黏膜下腭裂的临床价值。方法:收集2013年1月至2018年5月在济宁医学院附属医院行中晚期妊娠胎儿系统超声检查的孕妇21146例,均为单胎妊娠,常规留取胎儿硬腭后部腭骨水平板切面,将硬腭后部存在骨缺失定义为阳性病例,再行腭部针对性超声检查,观察软腭连续性,并与引产或分娩后结果相对照,追踪产后的诊治情况。结果:21146例胎儿中共检出单纯腭裂44例,包括显性腭裂23例和黏膜下腭裂21例。21例黏膜下腭裂胎儿中2例因合并其他畸形引产,19例出生。追踪19例出生患儿的诊治情况,15例患儿有3岁前口腔科就诊史,其中2例产前诊断时将显性腭裂误诊为黏膜下腭裂,余13例获得临床确诊。黏膜下腭裂超声表现为硬腭后部倒"V"形骨缺失和膜性连接,软腭完整但正中变薄或呈膜性高回声。结论:黏膜下腭裂具有特征性超声表现,产前超声可作出诊断,从而为出生后获得早期诊治提供一定依据。Objective To summarize the ultrasound manifestations of submucosal cleft palate,and explore the diagnostic value of prenatal ultrasound for submucosal cleft palate.Methods A total of 21146 pregnant women who underwent fetal ultrasound examination in the second and third trimesters in the Affiliated Hospital of Jining Medical University from January 2013 to May 2018 were collected.They were all singleton pregnancy.The ultrasound image which was the horizontal plate of the palatine bone at the posterior border of the fetal hard palate was routinely obtained.The presence of bone loss at the posterior border of the hard palate was defined as a positive case.Then the palate targeted ultrasound examinations of the positive cases were performed to observe the continuity of the soft palate.The ultrasound images of positive cases were compared with the results of induction or delivery,and their postpartum diagnosis and treatment were tracked.Results A total of 44 simple cleft palate were detected in 21146 fetuses,including 23 dominant cleft palate and 21 submucosal cleft palate.Two cases of 21 submucosal cleft palate were induced because of other deformities,the other 19 cases were born.The follow-up of the 19 submucosal cleft palate cases showed that 15 cases visited to stomatology department before 3 years of age,and 2 cases of newborns with dominant cleft palate were misdiagnosed as submucosal cleft palate by prenatal ultrasound,and the other13 of them were clinically diagnosed as submucosal cleft palate.The ultrasound of the submucosal cleft palate showed there was no inverted"V"-shaped bone in the posterior edge of the hard palate which was connected by a membranous connection,and the soft palate was complete,but the center of soft palate was thinner or even present membranous hyperechoic in ultrasound.Conclusions Submucosal cleft palate has characteristic ultrasound features,and prenatal ultrasound make a diagnosis and provide some basis for obtaining early diagnosis and treatment after birth.

关 键 词：超声检查 产前 黏膜下腭裂 

分 类 号：R714.53[医药卫生—妇产科学] R445.1[医药卫生—临床医学]