三维超声静态表面成像模式诊断胎儿脐带绕颈

目的 探讨三维超声全方位立体直观检测胎儿颈部表面解剖结构，并进一步精确诊断胎儿颈部脐带缠绕的实用价值。方法 采用静态表面成像模式，对215例胎儿颈部进行三维重建，以直接的镜面状效果显示其外表解剖结构特征。结果 215例要求检测脐带绕颈的孕妇中，三维超声检测出脐带异常5l例，发生率为23．72％。其中脐带搭颈23．53％，脐带绕颈l周52．94％，脐带绕颈2周13．72％，脐带先露9，8l％。重建的胎儿颈部形态直观、清晰、层次分明，富有质感；重建的脐带形态生动，定位、走向明确；重建的脐带绕颈图像一目了然，并可显示和判断绕颈的松紧程度。结论 三维超声能更全面、直观、形象地显示脐带绕颈的存在及其两者的空间解剖关系，进一步的研究应包括全程脐带在宫腔内的走势轨迹及其机理。

Three-dimensional Static Surface Rendering Ultrasound Detecting Fetal Nuchal Surface Formation and Umbilical Cord Coiling around Fetal Neck

Objective To study the cubic nuchal surface formation and structure of fetal neck in order to diagnose umbilical cord coiling around fetal neck by three-dimensional ultr asound (3DU). Methods 215 cases of pregnant women were reconstructed for feta l surface structural 3D images with the range from 12 to 40 gestational weeks by means of static surface rendering mode.Results Of the 215 subj ects, 51 cases (23 72 %) were diagnosed as having umbilical cord abnormalities by 3DU, including umbilical cord semi-coiling around fetal neck with the rate o f 23 53 %, one-ring coiling around fetal neck with the rate of 52 94 % and, 1 3 72 % of two-ring coiling respectively. The 3DU mode showed the fetal nuchal surface sophisticated characters such as general formation, figure, margin, smoo thness. In the meaning time, the reconstructed 3D image of umbilical cord displa yed vivid figure, spatial trend, and positional relationship between fetal neck and umbilical cord. The 3DU picture of umbilical cord coiling around fetal neck was to be clear of a glance. Also, the coiling tightening of umbilical cord may be estimated by the degree of the nuchal notch degree on the nuchal soft tissue. Conclusion 3DU supplied more detailed and comprehensive informa tion of umbilical cord coiling around fetal neck. On the other hand, the spatial relationship between fetal trunk, neck and umbilical cord was more graceful tha n 2D image and also could be understood easily by the examiner.