Cantrell五联征早孕期超声诊断价值分析  

Prenatal ultrasound diagnosis of pentalogy of Cantrell in the first trimester

作　　者：王莹莹 栗河舟[1] 王新霞[1] 李洁[1] 黎全华[1] WANG Ying-ying;LI He-zhou;WANG Xin-xia;LI Jie;LI Quan-hua(Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声科,河南郑州450052

出　　处：《中国临床医学影像杂志》2023年第3期196-198,209,共4页Journal of China Clinic Medical Imaging

基　　金：河南省医学适宜技术推广项目(SYJS2020080)。

摘　　要：目的:通过总结早孕期Cantrell五联征的超声图像特征,评估超声检查对早孕期Cantrell五联征的诊断价值,减少产前漏诊。方法:回顾性分析21例孕10~13周+6在我院行产前超声检查并诊断为Cantrell五联征胎儿的超声图像特征,并通过相关文献复习,对超声诊断价值及思路进行探讨。结果:本研究Cantrell五联征的26例胎儿中,早孕期诊断21例,诊断率为80.8%,漏诊1例,漏诊率为3.8%。1例诊断时胎死宫内,1例为单绒毛膜囊双羊膜囊双胎,余19例为单活胎,均经引产予以证实。42.9%(9/21)的胎儿整个心脏位于胸腔外,57.1%(12/21)的胎儿部分心脏位于胸腔外。71.4%(15/21)的胎儿腹壁缺损表现为脐膨出,28.6%(6/21)的胎儿腹壁缺损表现为腹裂。4.8%(1/21)的胎儿表现为单纯性Cantrell五联征,95.2%(20/21)合并其他畸形。合并畸形中9.5%(2/21)为颅脑异常,4.8%(1/21)为唇腭裂,47.6%(10/21)为脊柱发育异常,4.8%(1/21)为肋骨形态失常,42.9%(9/21)为肢体发育异常。14.3%(3/21)的胎儿NT增厚(NT≥3 mm),1例胎儿NT为正常高限值(2.7 mm),19.0%(4/21)的胎儿有颈部淋巴水囊瘤,14.3%(3/21)的胎儿有全身淋巴水囊瘤,23.8%(5/21)的胎儿脐带异常。结论:超声检查可以作为早孕期Cantrell五联征的首选诊断方法,但存在漏诊的可能,需要超声医师熟知该疾病的声像图表现,明确诊断思路。Objective:By summarizing prenatal ultrasound image features of pentalogy of cantrell in the first trimester,the diagnostic value of pentalogy of cantrell was evaluated to reduce prenatal missed diagnosis.Methods:The ultrasound image characteristics of 21 fetuses diagnosed with pentalogy of cantrell who underwent prenatal ultrasound examination at 10~13+6 weeks of gestation in our hospital were retrospectively analyzed.The diagnostic value and thoughts were summarized and analyzed by reviewing relevant literature.Results:Among the 26 fetuses diagnosed with pentalogy of cantrell in our hospital,21 were diagnosed in the first trimester with a diagnosis rate of 80.8%,and 1 case was missed with a missed diagnosis rate of 3.8%.One case was intrauterine fetal death,1 case was monochorionic diamniotic twins,and the remaining 19 cases were singleton,all of which were induced and confirmed.The 42.9%(9/21)cases were complete ectopic heart,and 57.1%(12/21)cases were incomplete ectopic heart.The 71.4%(15/21)of abdominal wall defects were omphalocele,and 28.6%(6/21)cases were gastroschisis.The 4.8%(1/21)cases were simply presented with pentalogy of cantrell,and 95.2%(20/21)cases were associated with other abnormalities.The combined malformations included 9.5%(2/21)craniocerebral abnormalities,4.8%(1/21)cleft lip and palate,47.6%(10/21)spinal abnormalities,4.8%(1/21)rib abnormalities,and 42.9%(9/21)limb abnormalities.14.3%(3/21)in 21 fetuses with increased NT(NT≥3 mm),1 fetus had a upper limit of normal NT which was 2.7 mm,cervical lymphatic hygroma was showed in 19.0%(4/21)fetuses,systemic hygroma was showed in 14.3%(3/21)fetuses,23.8%(5/21)in 21 fetuses with umbilical cord abnormalities.Conclusion:Ultrasound examination can be used as the preferred diagnostic method for pentalogy of cantrell in the first trimester.However,missing diagnosis may occur,which requires a clear idea of ultrasonic diagnosis.

关 键 词：坎特雷尔五联症 超声检查 产前 

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