胎儿鼻后三角在妊娠早期筛查颜面部畸形中的应用价值

目的探讨鼻后三角切面在妊娠早期筛查颜面部畸形中的价值,对比不同孕周组间鼻后三角的二维图像成像效果。方法将300例常规行11~13+6周超声检查的胎儿按孕周分为三组,分别为11~11+6周组65例、12~12+6周组115例及13~13+6周组120例。常规留取胎儿鼻后三角的二维图像,对比各孕周组间显示图像质量情况,对鼻后三角形态异常者进行分析。结果①各孕周组鼻后三角显示合格率情况:11~11+6周组为90.8%,12~12+6周组为92.2%,13~13+6周组为90.0%,三组间比较差异无统计学意义;②273例获得合格鼻后三角切面的胎儿中,鼻后三角形态异常者4例,其中2例鼻后三角顶点缺失合并腭骨回声缺失或中断,超声诊断为鼻骨缺失、唇腭裂;2例鼻后三角顶点缺失,超声诊断为鼻骨缺失;其余病例的随访结果与超声诊断符合;③27例鼻后三角切面显示不合格或无法成像的胎儿中,1例于孕22周行系统超声检查发现为唇腭裂并经出生后证实。结论鼻后三角是妊娠早期筛查鼻、腭部异常的可行、可靠的声像学标志。

Application value of retronasal triangle in ultrasound screening of fetal facial anomalies in first trimester

Objective To evaluate the value of the retronasal triangle section in ultrasound screening of fetal facial anomalies in first trimester, and to compare the two-dimensional imaging results of the retronasal triangle with different pregnancy weeks. Methods The two-dimensional images of the retronasal triangle were evaluated in 300 consecutive normal fetuses at the time of routine first-trimester sonographie screening at 11-13＋6 weeks＇ gestation. They were divided into 3 groups： 11-11＋6 weeks group, 12-12＋6 weeks group, and 13-13＋6 weeks group, respectively. The display qualified rate of the retronasal triangle was compared between different pregnancy weeks, and the retronasal triangle abnormal cases were analyzed. Results （1）The qualified rate of the display of retronasal triangle was 90.8% for 11-11＋6 weeks group, 92.2% for 12-12＋6 weeks group, and 90.0% for 13- 13＋6 weeks group, respectively. There was no difference in statistics. （2）Qualified retronasal triangle section was obtained in 273 fetuses. There were 4 cases with abnormal retronasal triangle. Among them, two cases with retronasal triangle vertex deletion combined with palate bone echo deletion or break off, were diagnosed as nasal bone deletion, cleft lip and palate. Two cases with retronasal triangle vertex angle deletion, were diagnosed as nasal bone deletion. All the follow-up resuhs of the cases were coincident with the ultrasound diagnosis. （3）The retronasal triangle section was not obtained or not qualified in 27 fetuses. Among them, one case with cleft lip and palate was detected in the 22 pregnancy weeks and confirmed after birth. Conclusion Retronasal triangle is a feasible and reliable ultrasonographic index for screening fetal facial anomalies in first-trimester.