产前超声对尿道下裂的诊断及分型价值  

Prenatal ultrasound for diagnosis and classification of hypospadias

作　　者：李小花[1] 赵伟[1] 刘阿庆[1] Li Xiaohua;Zhao Wei;Liu Aqing(Department of Ultrasonography,Affiliated Hospital of Jining Medical University,Jining 272000,China)

机构地区：[1]济宁医学院附属医院超声科,济宁272000

出　　处：《中华围产医学杂志》2024年第9期768-773,共6页Chinese Journal of Perinatal Medicine

基　　金：济宁市重点研发计划(2022YXNS024)。

摘　　要：目的探讨产前超声对尿道下裂的诊断及分型价值。方法回顾性分析2012年7月至2023年6月于济宁医学院附属医院就诊,产前超声疑似尿道下裂胎儿的临床资料。根据超声图像将尿道下裂分为重型及轻型。获取这些胎儿生后(引产后)确诊情况,分析产前超声对尿道下裂的诊断价值及分型符合情况。对数据资料采用描述性统计分析。结果(1)最终70例胎儿进入本研究,包括64例(91.4%)单胎,6例(8.6%)双胎之一;胎儿母亲年龄(31.3±5.1)岁,范围为21~50岁;诊断胎龄为(29.7±4.5)周,范围为21周+3~39周。15例(21.4%)母亲具有早孕期保胎史(包括前述6例双胎),9例(12.8%)母亲曾生育尿道下裂胎儿,4例(5.7%)父亲有外生殖器手术史(具体不详)。70例中,生后确诊尿道下裂49例(70.0%),17例(24.3%)引产终止妊娠,引产胎龄为(30.2±5.3)周,范围为26周+4~36周,引产后均行病理解剖证实尿道下裂。17例中的2例为孤立性尿道下裂,15例合并其他异常。(2)70例中的53例(75.7%)产前超声诊断为尿道下裂,其中重型29例,轻型24例;另17例无尿道下裂。生后(引产后)确诊尿道下裂49例,其中重型28例,轻型21例;另21例确诊无尿道下裂。(3)共36例产前超声发现尿道下裂合并其他超声异常。生后(引产后)确诊的28例重型尿道下裂病例中,24例(85.7%)合并其他超声异常;21例轻型尿道下裂病例中,12例(57.1%)合并其他超声异常者。产前超声诊断为尿道下裂的53例胎儿中,生后(引产后)证实46例诊断正确;产前诊断为重型尿道下裂的29例中,27例证实诊断正确;产前诊断为轻型尿道下裂的24例中,19例证实诊断正确;产前超声对尿道下裂、重型尿道下裂及轻型尿道下裂的阳性预测值分别为86.8%(46/53)、93.1%(27/29)和79.2%(19/24)。生后(引产后)确诊的49例中,3例(6.1%)产前超声漏诊,7例(14.3%)超声误诊,可能是未详细观察正中矢状切面胎儿阴茎末端形态所致。结论产前超声对�ObjectiveTo explore the diagnostic and classification value of prenatal ultrasound for hypospadias.MethodsA retrospective analysis was conducted on fetuses suspected of hypospadias based on prenatal ultrasound,who were treated at the Affiliated Hospital of Jining Medical University from July 2012 to June 2023.Hypospadias was classified as a severe or mild type based on ultrasound images.Postnatal diagnostic conditions of the live-born infants and fetal autopsy findings were obtained,and the diagnostic value and classification consistency of prenatal ultrasound for hypospadias,severe hypospadias,and mild hypospadias were analyzed.Descriptive statistical analysis was used for data analysis.Results(1)A total of 70 fetuses were included in the study;among them,64 were singletons(91.4%),and six were twins(8.6%).The maternal age was(31.3±5.1)years,ranging from 21 to 50 years.The gestational age at diagnosis was(29.7±4.5)weeks,ranging from 21+3 to 39 weeks.Fifteen mothers(21.4%)had a history of early pregnancy preservation(including the six twin pregnancies),nine mothers(12.8%)had previously given birth to fetuses with hypospadias,and four fathers(5.7%)had a history of reproductive surgery(specifics not detailed).Among the 70 cases,49(70.0%)were diagnosed with hypospadias after birth and 17(24.3%)pregnancies were terminated,with a gestational age of(30.2±5.3)weeks,ranging from 26+4 to 36 weeks.The post-delivery pathological autopsy confirmed hypospadias in all 17 cases,including two isolated hypospadias and 15 combined with other abnormalities.(2)Among the 70 cases,53(75.7%)were diagnosed with hypospadias by prenatal ultrasound,including 29 severe and 24 mild cases;the remaining 17 cases were not diagnosed with hypospadias prenatally.Postnatal(post-delivery)diagnosis confirmed hypospadias in 49 cases,including 28 severe and 21 mild cases.Additionally,21 cases were confirmed to have no hypospadias.(3)A total of 36 cases were detected with hypospadias and other abnormalities by prenatal ultrasound.Among the 28 cases di

关 键 词：尿道下裂 产前诊断 超声 分型 胎儿 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]