婴幼儿髋关节三维重建虚拟现实图像与二维超声的研究

目的通过应用三维重建虚拟现实图像对婴幼儿髋关节及其周围解剖结构骨形态特征与二维超声图像的拟合以及图像的匹配,从而实现对婴幼儿髋关节发育状况的正确评价。方法选取国人婴幼儿新鲜尸体标本20具(其中男10具,女10具),行64排螺旋CT骨盆扫描,将测量数据应用Amira软件建立三维重建虚拟现实图像,观察其骨形态特征及彼此的空间形态位置关系并进行二维超声平面的确定及超声图像的测量。结果二维超声髋关节冠状切面标准图像α角、?角测量结果分别为59.5°±0.8°、56.2°±0.5°,三维虚拟现实图像α角、?角测量结果分别为61.5°±0.4°、53.3°±0.4°,二者差异无统计学意义。结论通过对三维虚拟现实图像骨形态结构的研究,证实了二维超声法可以较准确地评价婴幼儿髋臼发育不良或脱位程度,二维超声法可以作为发育性髋关节脱位首选的检查方法。     

孕11～13~(+6)周胎儿鼻后三角的二维及三维超声观察及测量在临床的诊断价值

目的比较二维超声与三维断层超声显像(TUI)技术在孕11~13~(+6)周胎儿鼻后三角的观察和测量中的作用及其应用价值。方法选取我院进行产科超声颈项透明层厚度(NT)检查的孕11~13~(+6)周孕妇100例,分别应用二维和TUI于颜面部冠状切面观察孕11~13~(+6)周胎儿鼻后三角的完整性,测量鼻后三角的顶角,并分析鼻后三角顶角与头臀径(CRL)的相关性。结果 CRL为49.4~84.9 mm,平均(68.20±8.93)mm。鼻后三角的检出例数随CRL的增大而增加;对同一CRL范围,二维超声检出鼻后三角的胎儿例数多于TUI检出例数;随着CRL的增大,TUI测量鼻后三角顶角数值呈现减小趋势,二者中度相关(r=-0.518,P0.05)。58例胎儿的二维鼻后三角顶角为79.00°±2.70°(75.89°~85.09°),TUI测量鼻后三角顶角为77.72°±2.71°(72.81°~82.06°),二者比较差异无统计学意义。结论在孕11~13~(+6)周胎儿检查中,二维超声可以更快更简捷地扫查到鼻后三角,观察连续性是否中断;TUI能快速而准确地显示鼻后三角并测量其顶角,获得更完整清晰的鼻后三角切面。     

实时三维超声心动图对左右心室容积测量的对比研究

目的　探讨实时三维超声心动图测量左心室与右心室容积的方法及其准确性。方法　应用实时三维超声诊断仪与后处理工作站对 3 5例健康成人进行三维成像及后处理分析。分别采用心尖长轴 2平面法、4平面法、8平面法及 16平面法测量左心室容积 ,并与二维Simpson法所测容积进行对照 ;以 8平面法分别测量左心室与右心室每搏量 ,并进行对照分析。结果　 2平面法与 4平面法的左心室容积测值间差异有显著性意义 (P <0 .0 1) ;4平面法与 8平面法及 16平面法测值间差异无显著性意义 (P >0 .0 5 )。二维Simpson法与 4平面法所测左心室容积相关性好 (r =0 .90 ) ,但二维测值偏低 ,差异有显著性意义 (P<0 .0 5 )。 8平面法测得左心室每搏量与右心室每搏量相关性良好 (r =0 .98)。结论　实时三维超声心动图测量左心室与右心室容积的准确性高 ,可重复性好。对左心室容积测量建议临床采用长轴 4平面法。     

应用三维超声检测孕11+2～14+2周胎儿颈部透明层厚度的可行性分析

目的：探讨利用三维超声技术获得标准正中矢状切面测量颈部透明层厚度的可行性,评价三维超声技术在此方面是否有优越性。方法：对198例孕11+2～14+2周的胎儿应用二维超声及三维超声分别测量胎儿颈部透明层厚度,对比二者测量值是否有统计学差异。结果：对198例检测结果进行统计学分析,结果显示三维超声测量NT值与二维超声测量NT值统计学上无显著性差异（t=0.488,P=0.626＞0.05）,二者之间具有可比性,二者测得的颈部透明层厚度均与孕周呈正相关,三维超声及二维超声测得颈部透明层厚度与孕周相关系数分别为r=0.536,P<0.05;r=0.543,P<0.05。结论：应用三维超声重建功能及三维扩展成像技术能够获得测量胎儿颈部透明层厚度所需的标准正中矢状切面,因此三维超声在检测胎儿颈部透明层厚度方面是可行的。     

孕早期超声测量胎儿腹主动脉与肠系膜上动脉夹角用于预测先天性膈疝北大核心CSCD

目的观察孕早期采用超声测量胎儿腹主动脉与肠系膜上动脉(SMA)夹角(AS角)预测先天性膈疝(CDH)的价值。方法纳入206胎接受超声检查的孕早期胎儿,其中200胎正常,5胎经随访证实为CDH、1胎为巨大脐膨出;测量胎儿AS角及头臀长(CRL)。以组内相关系数(ICC)评价观察者间测量结果的一致性;采用Pearson相关性评价正常胎儿AS角与CRL的相关性。结果2名观察者测量AS角及CRL的一致性良好(ICC均>0.75,P均<0.05)。正常胎儿AS角平均为(37.02±9.41)°,AS角与CRL无明显相关(R^(2)=0.0004,P=0.783)。5胎CDH中,3胎为孤立性左侧膈疝,1胎为左侧膈疝合并多发畸形,1胎为右侧膈疝合并多发畸形,孕早期AS角均明显增大(73°~119°)。1胎孕早期SMA走行明显异常,AS角150°,超声诊断为巨大脐膨出。结论超声测量孕早期胎儿AS角操作简便,且不受胎儿大小影响;AS角增大可能对预测胎儿CDH具有一定价值。     

实时三维超声心动图测量室壁瘤左心室功能的临床应用

目的探讨实时三维超声心动图(RT-3DE)检测室壁瘤左心室功能的可行性与准确性。方法分别应用实时三维超声心动图和二维超声心动图测量了12个有室壁瘤的心脏,使用实时三维全容积成像勾画左心室心内膜面,结合实时三维测量分析软件,分别采用二﹑四﹑八平面法测量左心室功能;将三维测量的左心室功能与二维超声测量以及左心室造影测量结果相比较。结果实时三维超声心动图能显示室壁瘤左心室的整体形态;实时三维超声心动图测量的左心室射血分数(LVEF)与二维Simpson法及左心室造影测量的LVEF有较好的相关性(r=0.77,r=0.95,P0.01);但采用二维方法测量的左心室容积小于三维方法;使用三维各平面法测量左心室容积时,二平面法与四、八平面法测值之间差异存在统计学意义(P0.01),四平面法与八平面法测值之间差异则不存在统计学意义(P0.05)。结论实时三维超声心动图能准确测量室壁瘤左心室容积,为评价左心室功能提供了新的工具。     

三维超声观察胎儿胼胝体及小脑蚓部正中矢状面

目的探讨以横断面为初始平面的三维超声显示胎儿胼胝体及小脑蚓部正中矢状面的价值。方法随机选取在本院接受产前超声检查的孕妇60名,胎儿超声系统检查无异常。以标准透明隔小脑半球平面为初始平面,采集三维容积数据库并存储,用软件分析容积数据,并采集同一胎儿标准二维正中矢状面。分析三维超声第三平面显示胎儿胼胝体及小脑蚓部的显示率,测量该平面胎儿胼胝体的前后径及小脑蚓部的面积,并与同一胎儿二维正中矢状面测量值进行比较。结果采集60胎胎儿的三维容积数据库及二维图像。三维图像第三平面胼胝体显示率为95.00%(57/60),小脑蚓部显示率为95.00%(57/60);三维第三平面测量的胼胝体前后径及小脑蚓部面积与二维正中矢状面所测量的径线差异无统计学意义(P均>0.05)。结论三维超声有助于显示胎儿胼胝体及小脑蚓部的正中矢状面,对胎儿胼胝体及小脑蚓部的生长监测具有临床价值。     

实时三维超声心动图估测右心室容积的实验研究

目的:初步评价实时三维超声估测右心室容积的可行性和准确性。方法:应用Philips Sonos 7500型超声仪的实时三维超声系统采集10只离体猪心右室金字塔形数据库,结合相应三维容积测量软件分别用心尖长轴系列平面法测量右室容积,并与二维超声长度法和双平面Simpson法测值及离体猪心右室硅胶模型实测值比较。结果:所有离体猪心均获满意的实时三维超声显示,所得右心室三维形态与其硅胶模型实际形态很相似。各右室容量估测值间用方差分析、SNK检验:结果实时三维超声16平面法(64.05±18.20)ml、8平面法(61.83±17.99)ml和二维超声长度法(57.31±15.26)ml测值与猪心右室硅胶模型排水法实测值(62.94±15.82)ml差异无显著性(P>0.05),而4平面法(49.37±19.74)ml、2平面法(40.75±17.61)ml和二维超声双平面Simpson法(37.21±16.41)ml测值与猪心硅胶模型排水法实测值差异有统计学意义(P<0.05)。并且16平面(r=0.97,P<0.001)和8平面(r=0.94,P<0.001)法测值与硅胶模型排水法实测值更接近,其相关性高于二维超声长度法(r=0.82,P<0.012)和双平面Simpson法测值(r=0.79,P<0.018)。结论:实时三维超声可以快速显示右室三维立体结构,为右室容积估测提供又一准确、可靠的检查手段。     

第11-13周胎儿鼻后三角的二维三维超声观察和测量在临床的诊断价值

【】 目的 运用二维和三维超声断层超声显像技术(tomographic ultcasound imaging,TUI)观察在第11～13周胎儿鼻后三角(Retronasal triangle)的完整性,并测量鼻后三角的顶角,比较及评价二维超声与三维断层超声显像技术(TUI)在第11～13周胎儿鼻后三角的观察和测量中的作用。方法 对150名头臀径(Crown-Rump Length,CRL)在45-84mm范围内胎儿,分别运用二维和三维超声TUI技术在胎儿颜面部冠状切面观察鼻后三角的完整性。对100例接受超声筛查的孕妇,分别应用二维和三维超声TUI技术在第11～13周胎儿颜面部冠状切面测量鼻后三角的顶角。结果 二维超声及三维超声(TUI)均可获得颜面部斜冠状切面,正中矢切面及鼻后三角顶角;可观察鼻后三角及腭的连续性。     

二维超声及实时三维超声VOCAL技术评估膀胱容量的对比研究

目的 对照评估二维及三维超声技术测量膀胱体积的准确性.方法 采用二维超声和三维超声测量62例男性成人的膀胱体积.二维超声测量排尿前膀胱最大切面的3个径线(L、H、W),分别用数学公式(V=0.5×L×H×W)、经验公式(V=0.7×L×H×W)计算膀胱体积;获取膀胱的三维数据,应用其体积分析软件VOCAL(virtual organ computed-aided analysis technique)测量膀胱体积;排尿后测得的尿液实际体积作为对照;如有残余尿则用上述方法测量残余尿体积,将排尿前体积减去残余尿体积,再与膀胱实际排尿量比较.结果 经二维超声经验公式法、三维VOCAL法测得的膀胱体积与膀胱实际排尿量比较差异无统计学意义(P值分别为0.599、0.867).二维经验公式法与三维VOCAL法比较差异亦无统计学意义(P=0.660).二维数学公式法的膀胱体积偏小,与二维经验公式法、三维VOCAL法以及膀胱实际排尿量比较存在统计学差异(P<0.001).二维经验公式、二维数学公式、三维超声VOCAL法计算所得的体积及实际所测膀胱排尿量均有较好的相关性,且大容量膀胱的相关性较小容量好.结论 三维超声可快速获得膀胱体积.二维超声经验公式和三维超声测算膀胱体积准确可靠,为临床评价膀胱功能、下尿路梗阻等提供了有力手段.而二维超声数学公式则低估了膀胱的实际体积.     

Frontomaxillary facial angle in chromosomally normal fetuses at 11 + 0 to 13 + 6 weeks.

OBJECTIVE: To establish the normal range of the frontomaxillary facial (FMF) angle at 11 + 0 to 13 + 6 weeks of gestation. METHODS: In this prospective study, three-dimensional (3D) volumes of the fetal head were obtained from 500 pregnancies before fetal karyotyping by chorionic villus sampling (CVS), after screening by fetal nuchal translucency (NT) thickness and maternal serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 11 + 0 to 13 + 6 weeks. Only cases with a normal karyotype were included in this study. The FMF angle was measured off-line. In a subgroup of 150 cases the FMF angle was measured using 2D ultrasound before obtaining a 3D volume. In 50 cases the 3D volumes were used to measure the FMF angle by the same examiner twice and by another examiner once. RESULTS: The mean FMF angle decreased with crown-rump length (CRL) from 84.3 degrees at CRL 45 mm to 76.5 degrees at CRL 84 mm. There was no significant association between the FMF angle and fetal NT or serum PAPP-A or beta-hCG. In the volumes with paired measurements, the difference between two measurements by the same or two sonographers was < 5% in 95% of the cases. In the cases with paired 3D and 2D ultrasound measurements, the difference in FMF angles was < 8% in 95% of the cases. CONCLUSIONS: At 11 + 0 to 13 + 6 weeks the FMF angle decreases with fetal CRL but is not related to fetal NT or serum biochemistry. The measurement is reproducible and the results obtained by 3D and 2D ultrasound are similar.     

Frontomaxillary and mandibulomaxillary facial angles at 11 + 0 to 13 + 6 weeks in fetuses with trisomy 18.

OBJECTIVE: To define the relative position of the maxilla and mandible in fetuses with trisomy 18 at 11 + 0 to 13 + 6 weeks of gestation. METHODS: A three-dimensional (3D) volume of the fetal head was obtained before karyotyping at 11 + 0 to 13 + 6 weeks of gestation in 36 fetuses subsequently found to have trisomy 18, and 200 chromosomally normal fetuses. The frontomaxillary facial (FMF) angle and the mandibulomaxillary facial (MMF) angle were measured in a mid-sagittal view of the fetal face. RESULTS: In the chromosomally normal group both the FMF and MMF angles decreased significantly with crown-rump length (CRL). In the trisomy 18 fetuses the FMF angle was significantly greater and the angle was above the 95(th) centile of the normal range in 21 (58.3%) cases. In contrast, in trisomy 18 fetuses the MMF angle was significantly smaller than that in normal fetuses and the angle was below the 5(th) centile of the normal range in 12 (33.3%) cases. CONCLUSIONS: Trisomy 18 at 11 + 0 to 13 + 6 weeks of gestation is associated with both mid-facial hypoplasia and micrognathia or retrognathia that can be documented by measurement of the FMF angle and MMF angle, respectively.     

Frontomaxillary facial angle in fetuses with trisomy 13 at 11 + 0 to 13 + 6 weeks.

OBJECTIVE: To investigate the frontomaxillary facial (FMF) angle in fetuses with trisomy 13 at 11 + 0 to 13 + 6 weeks of gestation. METHODS: A three-dimensional (3D) volume of the fetal head was obtained before karyotyping at 11 + 0 to 13 + 6 weeks of gestation in 23 fetuses with trisomy 13. The FMF angle, defined as the angle between the upper surface of the maxilla and the frontal bone in a midsagittal view of the fetal face, was measured and compared to the angle in 500 chromosomally normal fetuses. RESULTS: In 10 of 12 (83.3%) fetuses with trisomy 13 and holoprosencephaly, the FMF angle was above the 95(th) centile of the normal range. In the 11 fetuses with no holoprosencephaly, the FMF angle was not significantly different from normal. There was no significant difference in the FMF angle between the trisomy 13 fetuses with and without facial cleft. CONCLUSIONS: In fetuses with trisomy 13, the FMF angle at 11 + 0 to 13 + 6 weeks of gestation is increased only in cases with associated holoprosencephaly.     

妊娠11~13+6周胎儿侧脑室脉络丛参数初步研究及异常病例分析

目的分析正常妊娠11~13⁺⁶周胎儿侧脑室脉络丛相关参数及其价值。 方法选取2017年1月至2021年1月在安徽医科大学第二附属医院超声诊断科行早孕期胎儿结构筛查的正常胎儿277例（妊娠11~13⁺⁶周）,测量胎儿双侧侧脑室脉络丛长径、面积及大脑镰长度（CF-L）,侧脑室脉络丛长径、面积,采用配对t检验分析左、右侧有无差异;侧脑室脉络丛平均长径（CP-L）、侧脑室脉络丛总面积（CP-A）、CP-L/CF-L与头臀长（CRL）的相关性采用Pearson相关性分析;以CRL作为自变量,CP-L、CP-A、CP-L/CF-L作为因变量,应用简单线性回归模型探索分析变量之间的关系,并建立CRL与相关参数测量值的线性回归方程;同时分析2017年1月至2022年3月在安徽医科大学第二附属医院超声诊断科行早孕期胎儿结构筛查发现的侧脑室脉络丛异常的11例胎儿（妊娠11~13⁺⁶周）的侧脑室脉络丛参数。 结果正常妊娠11~13⁺⁶周胎儿左侧与右侧侧脑室脉络丛长径、面积差异均无统计学意义（P均＞0.05）。CP-L与CRL呈线性正相关（r=0.681,P＜0.001）,线性回归方程为：CP-L=0.134×CRL＋0.577;CP-A与CRL呈线性正相关（r=0.736,P＜0.001）,线性回归方程为：CP-A=0.251×CRL-0.267;CP-L/CF-L与CRL呈线性负相关（r=-0.514,P＜0.001）,线性回归方程为：CP-L/CF-L=-0.047×CRL＋1.011。早孕期侧脑室脉络丛异常者共11例,其中3例为双侧侧脑室脉络丛融合,1例为无侧脑室脉络丛,1例为侧脑室脉络丛不对称,另6例为侧脑室脉络丛小。 结论妊娠11~13⁺⁶周时,CP-L、CP-A、CP-L/CF-L与CRL呈线性相关,为侧脑室脉络丛检查提供一个可参考范围,具有一定的临床意义。     

Frontomaxillary facial angle at 11+0 to 13+6 weeks' gestation-reproducibility of measurements.

OBJECTIVE: To assess the intra- and interobserver reproducibility in the measurement of the frontomaxillary facial (FMF) angle at 11+0 to 13+6 weeks' gestation and to investigate the effect of deviations from the exact mid-sagittal view on these measurements. METHODS: Three-dimensional (3D) volumes of the fetal face were used by two operators to measure the FMF angle in 50 chromosomally normal and 50 trisomy 21 fetuses. The measurements were taken in the exact mid-sagittal view and repeated after lateral rotation of the head by 5 degrees, 10 degrees and 15 degrees away from the vertical position of the occipitofrontal diameter axis. Mean difference and 95% limits of agreement between paired measurements of FMF angle by the same and by two different sonographers were determined. RESULTS: In the mid-sagittal plane the maxillary bone was rectangular shaped. Rotation away from this plane became easily recognizable because at a mean of 7 degrees (range, 4-10 degrees) the shape of the maxilla changed with the appearance of the zygomatic process of the maxilla and at a mean of 8 degrees (range, 4-12 degrees) the tip of the nose became invisible. In both the normal and trisomy 21 fetuses the FMF angle measured at 5-15 degrees was not significantly different from the one measured in the mid-sagittal plane. In 95% of the cases, the difference between paired measurements of the FMF angle by the same sonographer at the mid-sagittal plane was between -2.3 degrees and 3.0 degrees and at 15 degrees it was -1.0 degrees to 6.8 degrees. At the mid-sagittal plane, the difference in measurements between two sonographers was -3.1 to 3.0 degrees. CONCLUSION: The landmarks that define the mid-sagittal plane of the fetal face are the tip of the nose and the rectangular shaped maxilla. Measurement of the FMF angle is highly reproducible.     

颅面部五切面法在11~13+6周胎儿颅面部畸形诊断中的应用价值

目的探讨颅面部五切面法在早孕期胎儿颅面部畸形诊断中的应用价值。 方法回顾性选取2020年1月至2021年1月在四川省妇幼保健院行早孕期超声检查的孕妇9183例,所有孕妇均于孕11~13⁺⁶周行超声检查,应用颅面部五切面法观察胎儿颅面部形态、结构等,并对分娩后新生儿及引产后胎儿进行随访。 结果9183例孕妇均可获得满意的颅面部五切面,最终诊断颅面部异常52例,孕11~13⁺⁶周检出42例（80.7%,42/52）,其中无叶全前脑15例（喙鼻9例,独眼4例）,唇腭裂畸形5例,露脑畸形12例,无脑儿4例,脑膜脑膨出3例,开放性脊柱裂3例,42例均经引产后尸解或临床随访证实胎儿颅面部异常。10例早孕期未检出,于孕中期超声检查检出,包括小眼畸形2例,小耳畸形3例,单纯唇裂畸形3例,面裂畸形1例,鼻翼部分缺损1例。 结论胎儿颅面部五切面法能较全面评价胎儿颅脑及颜面部,是早孕期筛查胎儿颅面部畸形的有效方法。     

超声测量肾盂角在诊断胎儿马蹄肾中的应用价值

目的评价超声测量胎儿肾盂角在产前诊断胎儿马蹄肾中的应用价值。方法 32例马蹄肾胎儿为马蹄肾组,正常中晚孕胎儿200例为对照组,建立正常胎儿肾盂角范围并分析其与孕周相关性;并将对照组胎儿与已证实为马蹄肾胎儿的肾盂角进行比较,分析肾盂角在诊断马蹄肾的敏感性及特异性。结果对照组胎儿中孕期肾盂角(171±7)°,晚孕期(163±6)°,马蹄肾组肾盂角中孕期(110±10)°,晚孕期(100±11)°;马蹄肾组肾盂角较对照组小(P0.05)。对照组胎儿肾盂角与孕周呈负相关;以肾盂角140°为界,诊断胎儿马蹄肾的敏感性为97%,特异性为100%。结论超声观测肾盂角在诊断胎儿马蹄肾中有重要作用。     

Fetal trunk and head volume measured by three-dimensional ultrasound at 11 + 0 to 13 + 6 weeks of gestation in chromosomally normal pregnancies.

OBJECTIVE: To establish the relationship between fetal trunk and head volume measured by three-dimensional (3D) ultrasound and gestational age at 11 + 0 to 13 + 6 weeks of gestation. METHODS: The fetal trunk and head volume were measured using 3D ultrasound in 417 chromosomally normal fetuses from singleton pregnancies at 11 + 0 to 13 + 6 (median, 12 + 0) weeks of gestation. Regression analysis was used to determine the significance of the association between fetal volume and gestational age. The Bland-Altman analysis was used to compare the measurement agreement and bias for a single examiner and between different examiners. RESULTS: The fetal trunk and head volume increased linearly with gestation from a mean of 5.8 mL at 11 + 0 weeks to 33.3 mL at 13 + 6 weeks and 1 SD was 4.4 mL. There was also a significant linear association between fetal volume and crown-rump length (CRL), from a mean of 5.1 mL at a CRL of 45 mm to 37.5 mL at a CRL of 84 mm and 1 SD was 2.7 mL. However, within this gestational range, a doubling in CRL, from a mean of 48 mm at 11 + 0 weeks to 79 mm at 13 + 6 weeks, was associated with a 5-6-fold increase in fetal volume. The mean difference in fetal volume between paired measurements by the same sonographer was -0.87 mL (95% limits of agreement, -2.31 to 4.05 mL) and the mean difference between paired measurements by two sonographers was -1.09 mL (-5.49 to 3.32 mL). CONCLUSIONS: 3D ultrasound can provide a reproducible measurement of the fetal trunk and head volume in early pregnancy. At between 11 + 0 and 13 + 6 weeks there is a 5-6-fold increase in fetal volume but only a doubling in CRL.     

孕11~13+6周心脏畸形胎儿四腔心切面声像图特征

目的 观察孕11~13⁺⁶周心脏畸形胎儿四腔心切面声像图特征,探讨其在早孕期筛查中的价值。方法 回顾性分析24胎经病理、中孕期胎儿超声心动图检查或出生后随访证实的11~13⁺⁶周心脏复杂畸形胎儿心脏四腔心切面超声声像图特征和颈项透明层（NT）厚度。结果 24胎心脏畸形胎儿早孕期四腔心切面表现：①6胎正常,可见2束比例相当的心室流入道血流;②3胎表现为比例失调的2束血流;③5胎仅显示1束房室瓣血流,于心室水平再分为左右2束血流;④5胎显示1束房室瓣血流,于心室水平无分叉;⑤5胎表现为室间隔过隔血流。24胎中,16胎（16/24,66.67%）NT增厚,8胎（8/24,33.33%）NT正常。结论 11~13⁺⁶周四腔心切面超声表现对筛查胎儿心脏畸形具有一定价值,有望将部分心脏畸形的检查时间窗由中孕期提前至早孕期。     

11~13+6孕周超声筛查胎儿肢体畸形

目的 探讨11~13⁺⁶孕周产前超声筛查胎儿肢体畸形的价值。方法 对2011年1月-2013年3月接受11~13⁺⁶孕周胎儿颈项透明层检查的8158名孕妇（共8346胎）,采用连续顺序追踪法进行胎儿肢体检查,记录胎儿肢体畸形情况并追踪随访。结果 共5055胎获得随访结果,存在肢体畸形39胎。超声正确诊断肢体畸形22胎,产后或引产后发现漏诊16胎,[包括指(趾)畸形8胎、足内翻4胎、肢体姿势异常4胎],超声误诊1胎。结论 11~13⁺⁶孕周超声筛查可检出部分胎儿肢体异常,但肢体远端指（趾）畸形漏诊率高。