产前超声诊断单纯持续性卵黄动脉1例并文献复习  

Prenatal ultrasound diagnosis of isolated persistent vitelline artery:a case report and literature review

作　　者：刘凤琴 周柳英 舒娜 叶楠 奚级梅 Liu Fengqin;Zhou Liuying;Shu Na;Ye Nan;Xi Jimei(Department of Ultrasonography,the Affiliated Women's and Children's Hospital,School of Medicine,University of Electronic Science and Technology of China(Chengdu Women's and Children's Central Hospital),Chengdu 611731,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院(成都市妇女儿童中心医院)超声科,成都611731

出　　处：《中华围产医学杂志》2024年第3期209-214,共6页Chinese Journal of Perinatal Medicine

基　　金：四川省科技计划项目(2021YJ0244)。

摘　　要：目的总结分析胎儿持续性卵黄动脉的超声图像特征及预后。方法回顾性分析2021年12月电子科技大学医学院附属妇女儿童医院(成都市妇女儿童中心医院)诊断的1例单纯胎儿持续性卵黄动脉病例的产前超声图像特征、遗传学检查结果及预后。以“持续性卵黄动脉”“Ⅱ型单脐动脉”和“产前超声”为关键词,检索中国知网、维普中文期刊数据库、万方数据库和中华医学期刊全文数据库;以“persistent vitelline artery”“typeⅡsingle umbilical artery”和“prenatal ultrasound”为关键词,检索PubMed、Embase和UpToDate数据库。总结胎儿持续性卵黄动脉的产前超声图像特征及预后。对数据资料采用描述性统计分析。结果(1)病例报告:本例孕23周超声检查时,腹部可见1条异常粗大的血管起源于腹主动脉近肠系膜上动脉,经脐孔与脐静脉并行进入胎盘,彩色多普勒显示类似脐动脉血流频谱;膀胱横切面未见双侧脐动脉,游离段脐带横切面呈“吕”字形。余胎儿结构未见明显异常。遗传学检测未见异常。出生后该患儿(随访至1岁)生长发育未见异常。(2)文献复习:检索到文献5篇(英文文献3篇,中文文献2篇),共4个病例。结合本研究报道的1例,共5例。这5例中,4例未见明显胎儿结构异常,患儿出生后均生长发育良好;1例产前超声提示左肾缺如,心脏大动脉比值异常,父母选择终止妊娠。3例进行了脐带组织病理学检查,其中2例证实持续性卵黄动脉具有明显内膜弹性层,1例可见卵黄管残留。结论胎儿持续性卵黄动脉的产前超声特征为异常血管起源于腹主动脉或肠系膜上动脉,行使脐动脉功能。单纯持续性卵黄动脉预后较好,但目前国内外报道极少。应积累更多病例进一步研究,提高对此类胚胎异常的再认识。Objective To summarize the ultrasonographic features and prognosis of fetal persistent vitelline artery.Methods The prenatal ultrasound features,genetic testing results,and prognosis of a fetus with an isolated persistent vitelline artery that was diagnosed in our hospital in December 2021 were retrospectively analyzed.Relevant articles were retrieved from CNKI,VIP,Wanfang,Yiigle,PubMed,Embase,and UpToDate databases using the terms"persistent vitelline artery","typeⅡsingle umbilical artery",and"prenatal ultrasound"in both Chinese and English.Prenatal ultrasound features and prognosis of the persistent vitelline artery in fetuses were summarized using descriptive statistical analysis.Results(1)Case report:In this case,ultrasound at 23 gestational weeks showed that an abnormally large blood vessel deriving from the celiac artery near the superior mesenteric artery entered the placenta through the umbilical opening in parallel with the umbilical vein.Color Doppler showed a blood flow spectrum like that in the umbilical artery.The transverse section image showed that bilateral umbilical arteries were not observed in the bladder and the free segment of the umbilical cord was in the shape of the Chinese character"Lyu".No obvious other structural abnormalities and a negative result of genetic testing were observed in the fetus.Followed up to one year old,the patient showed normal growth and development.(2)Literature review:A total of five articles involving four cases were retrieved(three in English and two in Chinese).Among the five cases,including the present case,one was terminated due to left renal agenesis and abnormal heart arteries ratio revealed by prenatal ultrasound,and the remaining four cases without obvious structural abnormalities in the prenatal ultrasound were born and developed well.Histopathological examination of the umbilical cord was performed in three cases,of which two with persistent vitelline artery had a distinct internal elastic lamina,and one with remained vitelline duct.Conclusions The pre

关 键 词：超声检查 产前 单脐动脉 脐动脉 血管畸形 卵黄管 

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]