高频超声在孕早期胎儿肾脏检查中的临床应用研究  

Clinical application of high frequency ultrasound in fetal kidney examination in early pregnancy

作　　者：钟燕 段香凤 詹春华[1] ZHONG Yan;DUAN Xiangfeng;ZHAN Chunhua(Department of Ultrasound Medicine,The Third Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣南医学院第三附属医院超声医学科,江西赣州341000

出　　处：《当代医学》2022年第34期151-154,共4页Contemporary Medicine

基　　金：赣州市指导性科技计划(GZ2020ZSF121)。

摘　　要：目的探讨高频超声在孕早期胎儿肾脏检查中的临床应用价值。方法选取2020年1月至2021年3月于赣南医学院第三附属医院检查的1049名孕妇作为研究对象,均行高频超声检查。以引产标本解剖或随访结果为金标准,分析高频超声对胎儿肾脏发育异常检出情况及胎儿肾脏发育异常影像学。结果1049例孕妇中,高频超声检查显示,胎儿肾脏发育异常13例,其中肾积水3例,肾囊肿2例,双肾回声增强3例,巨膀胱1例,婴儿型多囊肾2例,肾缺如1例,多囊性肾发育不全1例。13例胎儿肾脏发育孕妇中,接受染色体相关检查6例,其中无创DNA检查4例,提示18-三体低风险2例,18-三体高风险1例,21-三体高风险1例;行羊水穿刺2例,提示核型正常1例,21-三体1例。6例孕妇因尿液浓缩检查、相关染色体检测或泌尿生殖系统结构严重异常,提示肾功能不全而选择终止妊娠,引产标本解剖显示,婴儿型多囊肾2例,肾囊肿1例,多囊性肾发育不全1例,肾缺如1例,巨膀胱1例;7例孕妇继续妊娠,其中伴随其他畸形或异常持续加重选择引产2例,正常生产5例。引产标本解剖或随访结果显示,双肾回声增强3例,肾积水3例,肾囊肿1例。引产标本解剖或随访结果与高频超声检查结果相同。肾积水超声显示,胎儿肾集合系统分离1~2 cm,肾盏无扩张为轻度肾积水;肾集合系统分离3~4 cm,肾盏轻度扩张为中度肾积水;肾区均为液性暗区,肾盏扩张明显为重度肾积水。双肾回声增强,即超声显示双肾区域出现回声增强。肾囊肿超声显示呈谷粒圆形、椭圆形或类圆形的规则状态;外周轮廓比较完整界限清晰边缘整齐,表面光滑;囊内回声呈均匀的无回声液性暗区,透声性一般较好;囊肿后侧回声增强或有侧壁后方狭窄的声音。巨膀胱超声显示,膀胱明显增大,纵径>7 mm,经尿液浓缩检查或明显泌尿生殖系统结构严重异常检查确诊。因严重尿道梗阻所致,�Objective To investigate the clinical application value of high frequency ultrasound in fetal kidney examination in early pregnancy.Methods 1049 pregnant women examined in the Third Affiliated Hospital of Gannan Medical University from January 2020 to March 2021 were selected as the research subjects,all the patients underwent high frequency ultrasound examination.The gold standard was to analyze the detection of abnormal fetal kidney development and imaging of abnormal fetal kidney development by high frequency ultrasound.Results Among the 1049 pregnant women,high-frequency ultrasound showed 13 cases of abnormal fetal kidney development,including 3 cases of hydronephrosis,2 cases of renal cysts,3 cases of double renal echo enhancement,1 case of giant bladder,2 cases of infantile polycystic kidney disease,1 case of renal deficiency,and 1 case of polycystic renal dysplasia.Among the 13 pregnant women with fetal kidney development,6 cases received chromosome related examination,including 4 cases of non-invasive DNA examination,indicating low risk of trisomy 18 in 2 cases,high risk of trisomy 18 in 1 case and high risk of trisomy 21 in 1 case.Amniotic fluid puncture was performed in 2 cases,indicating normal karyotype in 1 case and trisomy 21 in 1 case.6 pregnant women chose to terminate their pregnancy due to urine concentration examination,relevant chromosomal testing or serious structural abnormalities of the genitourinary system,suggesting renal insufficiency,and the autopsy of labor induction specimens showed that there were 2 cases of infantile polycystic kidney,1 case of renal cyst,1 case of polycystic renal hypoplasia,1 case of renal deficiency,and 1 case of giant bladder.7 pregnant women continued to be pregnant,including 2 cases of induction of labor with the persistent aggravation of other malformations or abnormalities,and 5 cases of normal delivery.The results of autopsy or follow-up of labor induction specimens showed that there were 3 cases of enhanced echo in both kidneys,3 cases of hydronephrosis an

关 键 词：胎儿肾脏 早孕期 高频超声 产前超声筛查 

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]