中孕期脐带螺旋的超声检查表现及分类  

Ultrasound manifestations and classification of umbilical cord helices in midpregnancy

作　　者：辛艳芬[1] 宋思思[2] 黄香 蒲英梅[1] XIN Yanfen;SONG Sisi;HUANG Xiang;PU Yingmei(Department of Ultrasound,Deyang People's Hospital,Deyang 618000,China;Department of Radiology,Deyang People's Hospital,Deyang 618000,China;Department of Ultrasound,MianzhuRenai Hospital,Deyang 618200,China)

机构地区：[1]四川省德阳市人民医院超声医学科,四川德阳618000 [2]四川省德阳市人民医院放射科,四川德阳618000 [3]四川省绵竹仁爱医院超声科,四川德阳618200

出　　处：《医学影像学杂志》2024年第6期98-101,共4页Journal of Medical Imaging

基　　金：四川省科技计划项目(编号:2021YFG0328);四川省德阳市科技计划项目(编号:2021SZZ108)。

摘　　要：目的运用超声检查观察比较中孕期不同脐带螺旋形态的超声特征及胎儿生长血流状况,探讨中孕期超声检查诊断异常脐带螺旋形态的临床价值。方法选取153例在我院产检的中孕期(22~24周)单胎妊娠孕妇的超声检查图像,观察153条脐带螺旋形态并进行超声分类,比较不同类型脐带的脐带螺旋指数(umbilical coiling index,UCI)、估测胎儿体重(estimated fetal weight,EFW),以及胎儿生长受限(fetal growth restriction,FGR)、胎儿血流多普勒异常、脐动脉栓塞发生率之间的差异性。结果153条脐带按照螺旋形态及螺旋程度分为串珠状脐带、绳索状脐带、不规则脐带三种类型,发生率分别为13.3%、30.1%、56.6%。串珠状脐带UCI明显高于绳索状脐带,差异有统计学意义(P<0.05),不规则脐带UCI超声检查无法测量。串珠状脐带的FGR、胎儿血流多普勒异常、脐动脉栓塞的发生率明显高于绳索状脐带与不规则脐带,差异有统计学意义(P<0.05)。结论超声检查能够识别中孕期不同脐带螺旋形态,测量高螺旋脐带UCI,其中串珠状螺旋形态与不良的胎儿宫内生长及血流异常状况有关,应当重视中孕期脐带超声检查。Objective To observe and compare the ultrasound characteristics of different umbilical helix morphology in mid pregnancy and fetal growth and flow Doppler status using ultrasound technology,and to explore the clinical value of ultrasound diagnosis of abnormal umbilical helix morphology in mid pregnancy.Methods We prospectively collected ultrasound images of 153 singletons in 22~24 weeks of gestation who underwent birth examination at our hospital,observed 153 cord helix morphology and performed ultrasound classification to compare the differences of umblical cord index(UCI),estimated fetal weight(EFW)of different types of cord,the incidence of fetal growth restriction(FGR),fetal flow Doppler abnormalities,and umbilical artery embolism.Results 153 umbilical cords were divided into three types according to the spiral morphology and spiral degree:beaded umbilical cord,cord-shaped umbilical cord and irregular umbilical cord.The incidence rates were 13.3%,30.1% and 56.6%,respectively.UCI of beaded umbilical cord was significantly higher than that of cord-shaped umbilical cords(P<0.05),and UCI of irregular umbilical cord could not be measured by ultrasound.The incidences of FGR,fetal flow Doppler abnormalities and umbilical artery embolism were significantly higher in beaded umbilical cord than those in cord-shaped and irregular umbilical cord(P<0.05).Conclusion Ultrasound can identify different umbilical cord helix morphology in mid pregnancy and measure UCI of high helix cord,among which the beaded helix morphology is related to poor fetal intrauterine growth and flow Doppler abnormalities.Urgent attention should be paid to umbilical cord ultrasound examination in mid pregnancy.

关 键 词：脐带螺旋形态 脐带螺旋指数 串珠状螺旋 超声检查 

分 类 号：R714.56[医药卫生—妇产科学] R445.1[医药卫生—临床医学]