胎儿超声心动图在胎儿先天性心血管异常中的诊断价值

目的:探讨超声心动图诊断胎儿先天性心血管畸形的临床价值,分析其漏诊及误诊原因,提高诊断的准确率.方法:12165例行产前胎儿超声心动图检查的孕妇为研究对象,将产前超声诊断结果与引产后尸体解剖结果、产后超声心动图诊断结果进行对比分析.结果:12165例胎儿超声心动图检出452例胎儿心血管异常,其中单纯性三尖瓣反流341例,左室假腱索30例,心腔内强回声光团17例,单纯性肺动脉瓣反流10例,结构性心血管异常54例.54例患者中超声诊断正确49例,占90.3%;误诊5例,占9.7%.结论:胎儿超声心动图是胎儿先天性心脏病产前检查的有效方法.     

产前诊断胎儿畸形39例分析

目的　探讨产前超声检查诊断胎儿畸形的价值。方法　回顾性分析我院 1994年 1月— 2 0 0 1年 7月B超诊断胎儿畸形 39例的情况。结果　 39例畸形儿中神经管畸形 2 4例 ,占 6 1.5 % ,其中 15例为多种畸形并存 ;颈淋巴囊肿 4例 ,泌尿系畸形及先天性心脏病各 3例 ,内脏外翻 2例、多发畸形、胸腹水、肢体畸形 1例。 39例畸形胎儿中合并羊水过多 18例 ,合并羊水过少 7例。结论　产前超声检查对诊断胎儿畸形有重要价值     

胎儿畸形产前超声筛查在基层医院开展的可行性研究

目的按照产前超声检查技术规范的标准,探讨基层医院胎儿畸形产前超声筛查可行性及其意义。方法收集2004年3月至2009年4月,10 630例孕妇接受胎儿畸形产前超声检查资料,以产后最终诊断为标准,评估产前超声诊断的价值。结果超声诊断胎儿先天性畸形共266例,畸形的发生率约为2.50%(266/10 630),畸形检出率88.96%(266/299),单发畸形228例,复合畸形38例;漏诊33例,其中小畸形和复杂畸形漏诊29例。结论基层医院在严格执行产前超声筛查技术规程同时,加强自身技术和服务能力,能有效地降低畸形儿的出生率及漏诊率。     

胎儿血管环的产前超声诊断分析

目的探讨胎儿先天性血管环的产前超声心动图表现。方法回顾性分析2012年1月~2015年12月我院经超声诊断的7例胎儿先天性血管环的产前超声表现及随访结果,总结其超声声像图特点。结果在7例胎儿先天性血管环中,右位主动脉弓3例,双主动脉弓1例,肺动脉吊带2例,左位主动脉弓伴迷走右锁骨下动脉1例;合并心内畸形:1例合并有法洛四联症,1例合并室间隔缺损,2例伴有永存左上腔静脉。完全性血管环产前超声主要表现为环绕气管周围的"U"形或"O"形血管环;不完全性血管环产前超声主要表现气管和(或)食管后的异常走行的血管,部分形成"C"形血管环。结论先天性血管环具有典型的声像图表现,产前超声诊断胎儿先天性性血管环具有重要临床价值。     

二维联合三维超声在产前早孕晚期胎儿心脏畸形诊断中的应用研究

目的探讨二维联合三维超声在产前早孕晚期胎儿心脏畸形诊断中的应用效果。方法选取我院检查就诊的早孕晚期孕产妇200例,对孕产妇通过二维联合三维超声对孕产妇进行超声心动图检查,比较分析产前超声诊断结果和产后结果。结果本次纳入研究的212例胎儿中,生产前通过二维联合三维超声检查患有先天性心脏畸形的胎儿有70例,经产后回访结果为78例,诊断符合率为89.74%。78例胎儿中严重畸形的胎儿有58例,占胎儿心脏畸形的74.36%,非严重畸形的胎儿(室间隔缺损)20例,占胎儿心脏畸形的25.64%。单纯4CV切面诊断胎儿先天性心脏畸形152例,占胎儿总数的71.69%。结论在产前早孕晚期心脏畸形胎儿筛查中应用二维联合三维超声检查具有较高的诊断准确率,且具有应用方便、操作简单、无创伤。     

胎儿心脏系统超声检查诊断胎儿冠状动脉瘘

冠状动脉瘘(coronary arterial?stulae,CAF)属于罕见的先天性畸形,占先天性心血管病的0.2%~0.4%[1]。高分辨率彩色多普勒超声的应用和胎儿心脏超声检查经验的积累,使产前胎儿冠状动脉瘘的诊断成为可能。本研究回顾性分析柳州市妇幼保健院产前系统超声诊断的7例胎儿冠状动脉瘘的声像图特点,并结合相关文献报道,探讨超声诊断胎儿冠状动脉瘘的方法,以提高其诊断价值。     

胎儿先天性膈疝的产前超声诊断

目的:讨论先天性膈疝的超声产前诊断及评估围生儿预后的方法.材料和方法:收集1999-09～2010-03在新华医院产科经产前诊断和出生后7d内诊断的先天性膈疝病例24例,比较分析不同类型膈疝二维声像图特点.结果:24例中产前诊断23例(95.8%),平均诊断时间在孕28+3周,新生儿存活6例(25%),均为左侧膈疝.有合并畸形的胎儿围生期结局均不良.结论:目前先天性膈疝胎儿的存活率仍较低,须根据超声检查胎儿膈疝的部位、肺发育情况、有无合并畸形综合评估胎儿的预后.     

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 回顾分析27例胎儿畸形患者的临床资料和超声声像图特征,均通过临床分娩或引产证实.结果 27例胎儿畸形中,产前超声准确诊断25例,诊断符合率为92.59%.结论 产前超声检查方便易行,对产前胎儿畸形诊断具有重要的价值,是临床产前诊断的首选方法.     

胎儿畸形产前超声诊断390例分析

目的：分析产前超声在胎儿畸形诊断中的临床价值,提高产前超声诊断水平。方法对我院自2009年9月至2014年5月经超声诊断的390例胎儿畸形进行回顾分析。结果单系统畸形268例,涉及中枢神经系统、泌尿系统、消化系统、颈部、胸部、胎儿水肿、胸腹壁、骨骼等,多系统畸形8例,此外有5例本院超声检查结果有漏诊及误诊。结论产前超声诊断安全有效,是检出胎儿畸形的可靠方法。     

永存动脉干的产前超声心动图表现特点及其鉴别诊断

目的分析产前超声心动图在诊断胎儿永存动脉干的临床使用价值,探讨其声像图特点和鉴别诊断,以及合并畸形和检查中注意的问题。方法采用全面、系统的多切面胎儿超声心动图连续扫查法,回顾性分析7例永存动脉干胎儿的产前超声心动图影像学资料。结果产前超声心动图共诊断永存动脉干7例,病理解剖证实永存动脉干6例(1例肺动脉闭锁被误诊为永存动脉干),均合并其他心内畸形。结论产前超声心动图在诊断、鉴别诊断永存动脉干有着很重要的实用价值。     

The clinical significance of increased echogenicity in the fetal abdomen

Seven cases of increased echogenicity in the fetal abdomen detected on prenatal sonography were reviewed for findings and causes. In four cases, the findings corresponded to calcification secondary to meconium peritonitis, infection, or unknown cause. One infant with meconium ileus had inspissated but noncalcified meconium corresponding to the increased echoes. In two cases, follow-up prenatal sonography was normal, and the neonate was also normal. Eight cases from the literature with increased echogenicity in the fetal abdomen were also reviewed: Two cases were secondary to meconium ileus, and six were caused by meconium peritonitis. Increased abdominal echogenicity on prenatal sonography may result from various processes that may affect obstetric and neonatal management.     

Amniography in prenatal diagnosis

The increasing use of prenatal diagnostic methods, including sonography and amniotic fluid analysis, has made it possible to suspect certain fetal defects at an early gestational age. In selected cases, accurate diagnosis of the specific malformation may have an effect on fetal and neonatal prognosis, and on prenatal counseling of the parents. As part of a large regional screening program for neural tube defects, we performed 28 midtrimester amniograms. We found 14 neural tube defects (nine spina bifida, four anencephaly, one Meckel syndrome), four abdominal wall defects, two tumors, and eight normal examinations. Radiographic examples of these malformations are presented, including previously undescribed findings in meningomyeloceles. The place of amniography in prenatal diagnosis is discussed.     

Ultrafast MR imaging of the fetus

OBJECTIVE: We examined the capability of ultrafast single-shot fast spin-echo imaging to assess different fetal organ systems compared with prenatal sonography, using autopsy or postpartum imaging as a standard of reference. SUBJECTS AND METHODS: Thirty women with complicated pregnancies (mean age of gestation, 190 +/- 54 days) underwent T2-weighted ultrafast MR imaging. MR images were analyzed with regard to diagnostic confidence in assessing abnormalities of fetal organ systems, and data were correlated with postpartum findings or necropsy. Results were compared with those of prenatal sonography. RESULTS: Using receiver operating characteristic curve analysis, diagnostic confidence of MR imaging was best for assessing the brain (area under the curve [Az] = 0.96) and spinal canal (Az = 1.0), uteroplacental unit (Az = 0.93), and lungs (Az = 0.91). Results for the heart (Az = 0.63) and extremities (Az = 0.77) were significantly lower than that of other organs (p < 0.001). Diagnostic accuracy increased with gestational age. No statistically significant difference between sonography and MR imaging was found for the detection of abnormality in any organ system. In three fetuses, MR imaging was superior to sonography in characterizing cerebral abnormalities. MR imaging was inferior to sonography in characterizing abnormalities of the heart and extremities. CONCLUSION: Our results indicate that ultrafast MR imaging can be used for in vivo fetal imaging, especially in assessing cerebral abnormalities. However, MR imaging should be restricted to situations in which sonographic findings are ambiguous or impaired.     

胎儿轻度肾盂扩张的超声诊断及临床意义

目的:探讨产前超声对胎儿轻度肾盂扩张的诊断及预后评估价值.方法:对产前超声筛查出的76例胎儿轻度肾盂扩张的病例进行随访观察.结果:76例中双侧轻度肾盂扩张的为41例,其中37例出生后缓解消失,4例仍存在肾盂扩张,包括3例染色体异常,1例后尿道畸形.单侧轻度肾盂扩张35例,其中34例出生后缓解消失,1例合并骨骼系统畸形....     

Sonography of facial features of alobar and semilobar holoprosencephaly

Twenty-seven cases of alobar/semilobar holoprosencephaly were reviewed to determine and classify the associated facial abnormalities detected with prenatal sonography. All but one case were diagnosed prospectively with sonography. Facial abnormalities were present in 24 of 27 cases and were detected in 14 (58%) of 24 fetuses on prenatal sonography. Prenatal abnormalities detected by sonography included cyclopia (four of five), ethmocephaly (two of three), cebocephaly (one of three), midline cleft lip (four of eight), lateral cleft lip (two of two), and mild hypotelorism (one of three). One or more extrafacial anomalies were present in 14 (52%) of 27 fetuses. Other major structural anomalies detected prenatally by sonography included meningomyelocele (two of two), renal dysplasia (five of six), omphalocele (three of four), esophageal atresia (zero of three), and cardiac defects (one of seven). Chromosomal analysis revealed abnormal karyotype in 13 (50%) of the 26 fetuses in which it was performed; the most common abnormality was trisomy 13 (seven cases). The perinatal mortality rate was 89% (24 of 27); three neonates with holoprosencephaly were alive when discharged from the hospital. It is concluded that when a major cystic abnormality of the fetal brain is detected, prenatal sonographic analysis of midline facial defect may allow more definitive diagnosis of alobar or semilobar holoprosencephaly; affected fetuses often have other major structural abnormalities, and the outcome is nearly always fatal.     

超声检查胎儿严重先天性心脏畸形12例漏诊及误诊的分析

目的:探讨超声筛查胎儿心脏及大动脉异常的检出率和诊断率的有效方法及注意事项。方法:应用二维超声图像对胎儿心脏进行四腔切面、左室流出道、右室流出道切面等心脏解剖结构检查,再用彩色多普勒血流图对胎儿心脏进行血流方向及速度的观察。结果:12例严重先天心脏畸形,其中误诊8例,漏诊4例。结论:超声医生对先天性心脏病知识的系统学习是提高筛查质量的关键。     

Fetal omphalocele and gastroschisis: pitfalls in sonographic diagnosis

The prenatal sonographic findings in 10 infants with omphalocele or gastroschisis diagnosed either by sonogram or by physical examination at birth are reviewed. There were six true-positive diagnoses, as well as two false-positive and two false-negative diagnoses by sonography. The false-positive cases resulted from confusion of umbilical cord with extruded bowel (1 case) and oligohydramnios coupled with improper scanning technique (1 case). The false-negative cases resulted from poor documentation of fetal anatomy (1 case) and confusion of extruded bowel with umbilical cord (1 case). These pitfalls may be avoided by using optimal scanning technique with documentation of fetal anatomy and pulsed Doppler sonography.     

产前系统性超声筛查在中晚期孕妇检查中的诊断价值

目的：探讨产前系统性超声筛查在中晚期孕妇检查中的诊断价值。方法总结和分析仪征市中医院2010年5月至2014年3月对孕22-32周3550例中晚期孕妇进行产前系统性超声筛查结果。结果本组3550例胎儿筛查中,胎儿畸形共80例（2．25％）,单发畸形71例,多发畸形9例,其中漏诊5例（0．14％）。在单发畸形中,神经系统畸形17例、泌尿系统畸形12例、心脏畸形10例、消化系统（包括腹部）畸形11例、骨骼系统畸形5例、呼吸系统畸形4例、颈面部8例、其他畸形4例。在漏诊5例中,胎儿复杂心脏畸形1例、腭裂1例、膀胱部分外翻1例、足内翻1例、肛门闭锁1例。结论产前系统性超声筛查对胎儿诊断检查中具有较高特异性和准确性,应作为产前孕妇检查的常规检查手段。