二维与实时三维超声联合诊断胎儿体表畸形的对比观察

目的:探讨二维及实时三维超声联合诊断胎儿体表畸形的临床价值。方法:对6 050例胎儿进行二维超声检查,疑有胎儿体表畸形者再进行二维及实时三维超声联合检查,并与产后结果相对照。结果:经产后证实65例胎儿154处体表畸形,单纯二维超声与二者联合超声诊断符合率分别为71.01%(108/154)及92.21%(142/154),两种方法比较差异有显著性(P<0.05)。结论:二维与实时三维超声联合诊断胎儿体表畸形明显优于单纯二维超声,具有较高的临床实用价值。     

三维超声成像诊断胎儿体表畸形的应用价值

目的探讨三维超声成像在诊断胎儿体表畸形中的临床应用价值.方法应用实时三维超声仪对974例孕妇、共990个胎儿进行产前二维及三维超声检查,统计并比较超声诊断与产后诊断的符合率.结果发现胎儿体表畸形22例51处,产前二维及三维超声对病变部位判断正确者分别为37处(72.5%)及47处(92.2%),能直观显示病变及对细节判断正确者分别为18处(35.3%)及46处(90.2%).结论三维超声图像立体、直观,为胎儿体表畸形的诊断提供了更丰富的信息,优于单纯使用二维超声,有较高的临床应用价值,是提高产前诊断水平的一个可靠的技术手段.     

动态三维超声诊断胎儿肢体畸形的临床价值

目的 探讨动态三维超声在产前诊断胎儿肢体畸形中的临床应用价值.方法 对862例孕妇进行胎儿肢体二维超声常规检查,对二维超声检查怀疑有肢体畸形的病例进行动态三维超声检查,并与引产或生产结果对照.结果 862例孕妇中有21例孕妇有生产或引产结果对照.21例胎儿肢体畸形的孕妇产前超声诊断19例肢体畸形共12种32处,诊断不全1例(2处),漏诊1例,产前动态三维超声诊断的准确率为90.5%;二维超声诊断的准确率为61.9%,二者比较差异有统计学意义(P＜0.05).结论 动态三维超声可明显提高胎儿肢体畸形产前诊断的敏感性及准确度.具有较高的诊断价值.     

二维连续顺序追踪超声法联合三维超声诊断胎儿肢体畸形

目的:探骨超声筛查胎儿肢体畸形的方法,了解胎儿肢体畸形的特点.方法:采用二维连续顺序追踪超声法常规行产前超声检查,发现肢体畸形或畸形不明显而形态或姿势异常者行三维超声检查,将产前超声诊断结果与引产或产后结果对照.结果:超声检出肢体畸形胎儿21例,涉及肢体51处.失访1例,1例合并的单脐动脉,1例合并的单侧肾脏缺如漏诊,余与引产或产后结果一致,超声诊断符合率90.2%.结论:二维连续顺序追踪超声法是筛查胎儿肢体畸形有效方法,三维超声可提高胎儿肢体畸形产前诊断的敏感性及准确性.     

实时三维成像技术在胎儿体表畸形筛查中的应用

目的探讨实时三维超声成像技术在胎儿体表畸形诊断方面的临床价值。方法应用二维及实时三维超声成像对410例胎儿进行产前超声检查,统计并比较两种诊断方法的总符合率及二维及三维图像提供的畸形部位、形态改变的准确性及直观性。结果发现胎儿体表畸形30例。二维超声能肯定诊断并与产后诊断相符的有18处（60．0％）,实时三维超声为26处（86．7％）,二者比较有显著性差异（P〈0．05）。结论实时三维超声诊断优于单纯使用二维超声,是提高产前诊断水平的一个可靠手段。     

采用二维、三维超声及连续顺序追踪超声法对胎儿肢体畸形产前超声诊断探究

目的:探讨采用二维、三维超声及连续顺序追踪超声法对胎儿肢体畸形产前超声诊断。方法:选取2016年1月-2018年7月在我院产检发现胎儿肢体畸形的50例孕妇的产前超声检查资料进行回顾性分析,所有孕妇均采用了二维和三维超声检测,且均采用连续顺序追踪超声法进行检查。观察并比较其产前超声诊断与产后结果;观察并比较两种超声检测方式对胎儿肢体畸形部位和细节检出准确率情况。结果:产后证实胎儿肢体畸形共41例,产前超声诊断共检出32例,其中漏诊9例,产前超声诊断符合率为78.0%;产后证实胎儿肢体畸形有6种32处,二维超声检测对三维超声检测胎儿肢体局部畸形部位和细节的准确率均明显高于二维超声检测方式(P0.05)。结论:在对胎儿肢体畸形的产前诊断中,二维超声联合三维超声检测利用连续顺序追踪超声法可有效检测胎儿肢体畸形,应用连续顺序追踪超声法可以进一步减少胎儿肢体畸形的漏检率,相比于二维超声诊断,三维超声诊断可以更加准确、清晰、直观的反应胎儿肢体畸形的部位以及细节,更有利于提高胎儿肢体畸形的检出率。     

二维超声和三维超声对胎儿颜面部畸形的诊断价值比较

目的 比较二维超声和三维超声对胎儿颜面部畸形的诊断价值。方法 选取2016年1月至2020年12月于我院进行产前检查的85例疑似胎儿颜面部畸形的高危孕中期孕妇作为研究对象,分别给予二维超声及三维超声检查。以分娩或引产后的结果作为诊断金标准,比较二维超声及三维超声诊断胎儿颜面部畸形的符合率;比较二维超声及三维超声对胎儿颜面部畸形的诊断价值及两种方法与金标准检出情况的一致性。结果 85例疑似胎儿颜面部畸形的孕妇中,24例在本院完成引产或分娩后证实为颜面部畸形;三维超声诊断胎儿颜面部畸形的符合率为83.33%(20/24),高于二维超声的45.83%(11/24)(P<0.05)。三维超声对胎儿颜面部畸形的诊断灵敏度、准确度、漏诊率、阴性预测值均显著优于二维超声（P<0.05）;三维超声对胎儿颜面部畸形的诊断结果与金标准检出情况的一致性极高（Kappa=0.849,P<0.01）。结论 相较于常规的二维超声,三维超声对胎儿颜面部畸形的诊断价值较高,值得在高危孕妇产前检查中推广应用。     

实时三维超声诊断胎儿肢体畸形的临床应用研究

目的探讨三维超声诊断胎儿肢体畸形的临床应用价值。方法对我院接诊的162名孕妇,分别采用二维超声和实时三维超声检查进行检查,对两者诊断结果进行统计学比较。结果162名孕妇中,产后诊断结果四肢畸形胎儿者17例(10.5%)21处。三维超声的肢体畸形检出率为9.3%,高于二维超声的肢体畸形检出率(7.4%),但两者与产后诊断结果相比差异无统计学意义(P>0.05)。采用实时三维超声对胎儿肢体畸形高危孕妇进行产前检查,具有快速、准确率高、无创伤等优点,适合于胎儿肢体畸形的早期诊断和筛查。     

胎儿泌尿系统畸形产前、产后超声检查与尸体解剖结果的对比研究

目的 评价胎儿泌尿系统畸形产前超声诊断准确率,探讨泌尿系统畸形产前、产后超声扫查方法,探讨产后超声诊断泌尿系统畸形的可靠性.方法 对产前超声检查发现单纯泌尿系统畸形或合并其它系统畸形且父母决定引产并同意尸体解剖的21例胎儿的尸体行高频超声检查并解剖,对比分析产前、产后超声检查及尸体解剖结果.结果 21例中,产前超声发现泌尿系统异常19例,灵敏度为90.5%;产后高频超声检查均发现泌尿系统异常,灵敏度为100%.21例中,泌尿系统畸形共33处(除外3处输尿管畸形),产前超声准确诊断22处(66.7%),漏诊6处(18.2%),误诊5处(15.1%).产后高频超声检查准确诊断30处(90.9%),漏诊1处(3.0%),误诊2处(6.1%).结论 产前超声发现胎儿泌尿系统畸形的灵敏度较高,但对畸形的归属能力的判断还有待进一步提高;泌尿系统畸形的胎儿尸体高频超声检查与尸体解剖结果符合率较高,在家属拒绝尸体解剖时,可作为替代尸体解剖的另一种选择.     

三维超声诊断胎儿肢体局部畸形的价值

目的 评价三维超声用于诊断胎儿肢体局部畸形的价值.方法 对接受产前系统超声检查的10 096例、妊娠(28±6)周的胎儿进行肢体二维超声常规检查,对二维超声检查怀疑有肢体局部畸形的病例进行三维超声检查.对产前超声诊断肢体局部畸形的胎儿进行产后随访,比较二维超声与三维超声对肢体局部畸形部位及细节的显示情况.统计学分析采用卡方检验.结果 二维超声与三维超声对胎儿肢体局部畸形部位的诊断准确率分别为83.95%、91.36%,差异无统计学意义(P=0.152);对肢体局部畸形细节的诊断准确率分别为61.73%、79.01%,差异有统计学意义(P=0.016).结论 三维超声对胎儿肢体局部畸形细节的诊断准确率优于二维超声,其诊断价值较肯定.     

不同孕周的胎儿泌尿系统畸形的三维超声产前诊断及预后评估

目的:探讨不同孕周的胎儿泌尿系统畸形的三维超声产前诊断及预后评估.方法:以2016年1 月-2018年12月在我院行产前检查的1 288例孕妇作为研究对象.均进行二维、三维超声检查,分娩或引产后进行确诊.结果:1 288例孕妇共分娩或引产1 307例胎儿,根据引产尸检或分娩后确诊检查以及随访结果,发现泌尿系统畸形共35...     

Two-dimensional ultrasound is accurate in the diagnosis of fetal craniofacial malformation.

OBJECTIVE: To assess the accuracy of antenatal ultrasound in the diagnosis of craniofacial malformations and to compare two-dimensional with three-dimensional ultrasound. METHODS: This was a retrospective study in which the archives of our ultrasound laboratory were searched for cases with an ultrasound diagnosis of craniofacial malformation in the period 1986-2001. No attempt was made to look for false-negative diagnoses. RESULTS: Sixty cases with an antenatal diagnosis of a craniofacial malformation were found: 37 with cleft lip/palate; 17 with heterogeneous dysmorphisms (including mostly micrognathia and craniosynostosis) and 6 with miscellaneous craniofacial malformations. Associated anomalies were present in 48/60 (80%) cases, and holoprosencephaly (25 cases) was the most frequent of these. In 43 (72%) cases the diagnosis was made before 24 weeks' gestation. Postnatal follow-up was available for 43 cases and there was always complete correlation between antenatal and postnatal diagnoses. Cleft lip/palate was always accurately differentiated from cleft lip. Three-dimensional ultrasound was performed in 12 cases and was successful in 11. However, it did not provide further diagnostic information with regard to the two-dimensional scan. DISCUSSION: Current two-dimensional ultrasound in expert hands allows an accurate diagnosis of craniofacial abnormalities from early gestation. In our hands, three-dimensional ultrasound did not add any valuable diagnostic information. Three-dimensional ultrasound may facilitate the understanding of the lesion by the parents and facilitate communication with the plastic surgeons. However, these potential benefits need to be carefully weighed against the costs of the ultrasound instrumentation, increased examination time and training of personnel.     

产前超声对胎儿畸形的诊断价值

目的 探讨产前超声对胎儿畸形的诊断价值.方法 常规产前超声检查出畸形胎儿76例,并与引产后尸体解剖结果进行对照分析.结果 76例胎儿畸形中,单发畸形54例,占71.1%,多发畸形22例,占28.9%.产前超声检出畸形90处,产后诊断畸形126处,检出率71.4%.结论 产前超声检查对筛查胎儿畸形具有重要临床意义.     

胎儿畸形的产前系统超声筛查结果回顾性分析

目的研究产前系统超声检查对胎儿畸形的诊断价值,分析畸形胎儿的特征分布情况及漏诊原因。方法回顾性分析2016年1月至2020年1月于重庆市垫江县人民医院超声科行产前系统超声检查的10017例孕妇的临床资料。采用彩色多普勒超声仪进行胎儿畸形诊断,分析胎儿畸形的特征分布情况、漏诊类型及结局。结果共检出胎儿畸形110例,畸形率为1.10%。其中,单发畸形95例,占比为86.36%,复合畸形15例,占比为13.64%。110例畸形儿经出生后、引产以及尸检或染色体检查证实。超声漏诊9例,漏诊率为7.56%。结论产前系统超声检查对胎儿畸形的检出率较高,可促进优生优育,临床意义重大。     

实时三维超声对胎儿唇腭裂的诊断价值

目的应用实时三维超声成像诊断胎儿唇腭裂,就其诊断价值与二维超声诊断进行比较探讨。方法应用esaote Mylab 90实时三维超声显像仪,三维容积探头和二维腹部探头,对2798例16～40周胎儿唇部进行观察。结果 2798例中,应用实时三维或二维超声能看到胎儿唇部者2644例,显示率为94.5%,看不清胎儿唇部者154例。二维显示率为84.6%(2367/2798),实时三维显示率为89.7%(2510/2798)。应用实时三维或二维超声共发现胎儿唇腭裂畸形11例,与引产或足月产后相符合。二维及实时三维超声产前均检出唇腭裂10例,漏诊1例,检出率90.9%(10/11)。结论实时三维超声在诊断胎儿唇裂中图像逼真直观,对二维图像具有重要的补充作用,二者结合诊断胎儿唇腭裂是更有效的方法。     

多平面三维超声诊断膀胱肿瘤及其术前分期

目的 探讨多平面三维超声结合表面三维成像诊断膀胱肿瘤及其术前分期的应用价值.方法 对75例膀胱肿瘤患者进行二维、多平面三维和表面三维超声检查,并与手术病理诊断和分期结果及CT术前分期结果进行对照.结果 二维与三维超声诊断符合率分别为 93.3%与 98.7%;二维与三维超声分期诊断符合率分别为 83.5%与 93.2%,两者差异有统计学意义(P＜0.05);术前CT对膀胱肿瘤的诊断符合率为 90.7%,分期符合率为 79.7%.将三维超声分期符合率与CT分期对照,两者差异有统计学意义(P＜0.05).结论 多平面三维超声结合表面三维诊断膀胱肿瘤及其对肿瘤的术前分期符合率较高,可为临床诊断本病提供更多的信息.

Abstract：

Objective To evaluate the clinical value of multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging in diagnosing and staging bladder tumors.Methods Seventy-five patients were examined with three-dimensional ultrasound and two-dimensional ultrasound.In addition,54 cases were undergone preoperative multislice spiral CT.All cases were proved by pathology after operation.Results The qualitation accuracy in the diagnosis of bladder tumor with two-dimensional ultrasound was 93.3%(70/75) and that of three-dimensional ultrasound was 98.7%(74/75).The staging accuracy rates with two-dimensional ultrasound and three-dimensional ultrasound were 83.5%(106/127) and 93.2%(123/132) respectively.The difference of bladder tumor staging between three-dimensional ultrasound and two-dimensional ultrasound was significant (P＜0.05).The qualitation accuracy in the diagnosis of bladder tumor with CT was 90.7%(49/54).The preoperative staging rate of CT was 79.7%(59/74),compared with that of three-dimensional ultrasound,the difference was significant(P＜0.05).Conclusions Multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging can provide useful information and makes an improvement in detecting and staging bladder tumors.     

Accuracy of ultrasonography in diagnosis of fetal central nervous system malformation

BACKGROUNDPrenatal examination is an important measure for the screening and diagnosis of fetal malformations.AIMTo investigate the accuracy of ultrasonography in the diagnosis of fetal central nervous system (CNS) malformations.METHODSOne hundred and thirteen pregnant women suspected of having fetal CNS malformations were examined at our hospital from December 2018 to October 2020 using two-dimensional ultrasonography and three-dimensional ultrasonography, respectively. RESULTSAccording to the pathological results, there were 79 cases of CNS malformations and 34 cases of non-CNS malformations among the 113 pregnant women suspected of having fetal CNS malformation. Fifty-one cases of CNS malformation and 26 cases of non-CNS malformation were detected by two-dimensional ultrasonography, and 73 cases of CNS malformation and 30 cases of non-CNS malformation were detected by three-dimensional ultrasonography. The diagnostic sensitivity (92.41%) and accuracy (91.15%) of three-dimensional ultrasonography were higher than those of two-dimensional ultrasonography (64.56% and 68.14%, respectively) (P = 0.000). The specificity of three-dimensional ultrasonography (88.24%) was higher than that of two-dimensional ultrasonography (76.47%); however, the difference was not significant (P = 0.203). CONCLUSIONThree-dimensional ultrasonography has high application value in the diagnosis of fetal CNS malformations. In addition, the image quality is clear, and the diagnostic sensitivity and accuracy are high.     

孕早期颈项透明层超声联合孕中期彩色多普勒超声可提高产前胎儿畸形检出率

目的探究孕早期颈项透明层（NT）超声联合孕中期彩色多普勒超声在产前胎儿畸形筛查中的应用价值。方法选择2017年8月~2019年12月在我院行胎儿畸形筛查的2417例孕妇作为研究对象,所有孕妇于孕11~14周行NT超声检查,并于孕22~28周行二维、四维彩超检查。以引产或分娩结果为“金标准”,比较畸形胎儿、正常胎儿的NT值及NT异常率,对比NT超声检查、二维联合四维彩超检查结果,并就NT超声、二维及四维彩超及二者联合在诊断胎儿畸形中的诊断率进行比较。结果2417例孕妇最终确诊异常胎儿88例,发病率为3.64%。畸形胎儿的NT值明显高于正常胎儿,NT异常率（93.18%）明显高于正常胎儿（1.33%）,差异比较有统计学意义（P < 0.05）。NT超声检查共检出异常胎儿82例,诊断准确率为93.18%;二维联合四维彩超共检出异常胎儿85例,诊断准确率为96.59%。二维联合四维彩超的诊断准确率略高于NT超声检查,差异无统计学意义（P>0.05）。NT超声联合二维、四维彩超在诊断胎儿畸形中的敏感度、特异度和准确度分别为100.00%、99.57%、99.59%,高于NT超声、二维和四维彩超（分别为93.18%、98.67%、98.47%和96.59%、99.06%、98.97%）,组间比较差异有统计学意义（P < 0.05）。结论孕早期NT超声及孕中期彩色多普勒超声在产前筛查胎儿畸形上各具有优势,均具有较好的诊断价值。二者联合应用能够进一步提升胎儿畸形的检出率,对尽早终止胎儿畸形孕妇继续妊娠,减少畸形胎儿出生具有重要意义。      

实时三维超声心动图对三尖瓣下移畸形的诊断价值

目的探讨实时三维超声心动图对三尖瓣下移畸形的诊断价值。方法超声心动图诊断为三尖瓣下移畸形的患者18例,使用实时三维超声显示三尖瓣的结构、形态、瓣膜反流情况,以及房化右心室和右心室的形态、功能,然后进行三尖瓣下移畸形和三尖瓣前叶功能（Ess）分级,并与手术结果进行对照。结果三维超声心动图显示18例患者中二维超声误诊2例,余16例患者行ESS分级：A级2例,B级11例,c级3例;三尖瓣反流轻度2例,中度9例,重度5例;合并房间隔缺损14例。手术证实三维超声诊断准确率100％。结论三维超声结合二维超声心动图能准确显示三尖瓣下移畸形,为手术医师提供更多的实用信息。     

二维联合动态三维超声时空关联成像技术诊断胎儿完全型心内膜垫缺损

目的探讨二维联合动态三维超声时空关联成像(STIC)技术诊断胎儿完全型心内膜垫缺损(CTECD)的价值。方法应用超声心动图检查28 388例孕18~40周的胎儿,二维及彩色多普勒超声以胎儿四腔心切面为常规扫查切面,多切面扫查观察胎儿心脏大小、形态、房室结构、房室瓣开闭、左右心室流出道及其血流动力学改变,发现心脏解剖结构异常后应用动态三维超声STIC技术实时、动态观测胎儿三维房室结构及其血流动力学改变。结果本组28 388例孕妇中,超声心动图明确存在先天性心脏病胎儿861例,其中诊断CTECD 68例。结论二维联合动态三维超声STIC技术可诊断胎儿CTECD,可在短时间内直观地显示胎儿CTECD的大小、形态及其血流动力学改变。