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。      

产前超声诊断三胎妊娠伴双胎无心脐动脉反向灌注序列征

目的总结三胎妊娠伴双胎无心脐动脉反向灌注序列征（TRAPS）胎儿产前超声图像特点。 方法对2001年4月至2017年4月经湖北省妇幼保健院产前超声诊断和生后检查确诊的6例三胎妊娠伴TRAPS胎儿超声与病理检查结果进行对照分析,总结TRAPS胎儿产前超声图像特点。 结果产前超声显示：（1）6例三胎妊娠伴TRAPS胎儿中无心畸胎均有发育不良的下肢（1例有发育不良上肢）,无胸腔、无心脏结构及心管搏动,5例无头颅结构,1例有发育不良头;4例有脊柱和腹腔结构;4例为单脐动脉,5例伴全身皮肤水肿;彩色多普勒示脐动脉反向灌注朝向胎儿体内,2例产前超声末显示脐动脉及胎儿体内血流。（2）6例泵血儿解剖结构均正常,羊水过多2例,羊水正常4例。胎儿期发生心功能不全3例（1例中孕早期好转存活,2例宫内死胎）。（3）6例第三胎儿中5例解剖结构正常,1例多发畸形。胎儿预后：6例三胎妊娠伴TRAPS胎儿中1例剖宫产产下2个正常男婴,1个死胎（无心畸胎）;其余5例三胎均预后不良（5例泵血儿中4例宫内死胎,1例早产死亡;5例第三胎儿中1例宫内死胎,2例早产死亡,2例引产;5例无心畸胎中4例宫内血流阻断,1例生后死胎）。产后病理检查显示6例均为三胎妊娠伴TRAPS,其中4例为双绒毛膜三羊膜三胎妊娠,1例为双绒毛膜双羊膜三胎妊娠;1例为单绒毛膜三羊膜三胎妊娠。 结论三胎妊娠伴TRAPS为罕见而严重的多胎妊娠并发症,产前超声有特有的声像图特点,彩色多普勒超声有较高的诊断价值。     

Marked splenomegaly in fetal cytomegalovirus infection: detection supported by three-dimensional power Doppler ultrasound.

An enlarged fetal spleen can be associated with fetal infection, anemia and different syndromes but its prenatal diagnosis is rare. We report on a diagnosis of splenomegaly at 32 weeks' gestation in a fetus which was found to be affected by cytomegalovirus infection. An enlarged spleen was suspected when the stomach was found to be displaced anteriorly and medially and the diagnosis was supported on visualization of the splenic vessels by color and three-dimensional power Doppler ultrasound. The patient had been referred because of fetal growth restriction and intracerebral anomalies and the additional finding of splenomegaly was highly suspicious for cytomegalovirus infection. This was confirmed by positive maternal serology and by neonatal virus excretion in urine. Retrospectively, examination of stored blood samples from 9 and 23 weeks' gestation revealed an early cytomegalovirus infection. Antenatal and neonatal magnetic resonance imaging examinations showed microcephaly, lissencephaly and the presence of microcalcifications. At the age of 9 months, the child suffers from severe neurological impairment and blindness due to severe optical atrophy. This case emphasizes that color Doppler and three-dimensional power Doppler ultrasound can facilitate the antenatal diagnosis of splenomegaly and can help to delineate the spleen from the similar-looking neighboring liver.     

Prenatal diagnosis of a subdural hematoma associated with reverse flow in the middle cerebral artery: case report and literature review.

To our knowledge this is the first reported case of a subdural hematoma, related to fetal autoimmune thrombocytopenia, diagnosed prenatally by ultrasound. The underlying etiology was hidden maternal autoimmune thrombocytopenia. This disease, which is as serious as alloimmune thrombocytopenia, causes severe fetal thrombocytopenia, which carries with it a high risk of intracranial hemorrhage and recurrence in subsequent pregnancies. Only 14 cases of fetal subdural hematomas have been reported in the literature. The etiologies of these cases were principally traumatic, or due to disorders of hemostasis. Their prognoses were generally poor, with 50% resulting in fetal death in utero and the remaining 50% demonstrating post-natal sequelae. The presence of reverse flow in the middle cerebral artery is rare and its association with a subdural hematoma unusual. Abnormalities found on cerebral Doppler studies indicate an adaptive response to a fetal condition for which the prognosis is then very poor. Monitoring fetuses at risk for hemorrhage by ultrasound imaging and Doppler studies enables us to detect indicators of a worsening prognosis before the ultrasound appearance of morphological hemorrhage. The development of intracranial hemorrhage raises difficult management issues during the index pregnancy and in subsequent pregnancies.     

胎儿肝脏血管瘤的产前超声影像学特征及预后

【目的】探讨胎儿肝脏血管瘤的产前超声影像学特征及预后。【方法】回顾性分析2014年1月至2018年10月在本院产前超声检查发现的胎儿肝脏实性肿块且产后证实为肝脏血管瘤的患者15例,分析产前超声影像学特征,并追踪其预后。【结果】15例病例中13例产前超声提示胎儿肝内血管瘤,2例误诊为肝母细胞瘤(其中1例引产、1例活产分娩),产前超声诊断正确率为86.7%(13/15)、误诊率为13.3%(2/15);15例中2例为高回声、1例为等回声、5例为低回声、7例为混合回声;15例中13例活产分娩、2例引产,13例活产婴儿经彩色多普勒超声或增强CT扫描或MRI检查证实为肝血管瘤,2例引产胎儿在孕妇知情同意的前提下经尸体解剖及病理检查证实为肝血管瘤。13例活产婴儿均采取保守治疗,治疗期间行彩色多普勒超声随访观察6~36个月,均预后良好。【结论】胎儿肝脏血管瘤的边界、内部回声、血流信号等有一定特点,但是缺乏特异性,产前超声对胎儿肝脏血管瘤的诊断有一定价值,肝血管瘤患儿经保守治疗预后良好。     

彩色多普勒超声诊断胎儿永久性右脐静脉的价值

目的:探讨彩色多普勒超声对胎儿永久性右脐静脉的诊断价值及临床意义。材料与方法:对我院行系统产前超声检查的胎儿全部进行脐静脉走行跟踪,发现永久性右脐静脉胎儿后,仔细检查静脉导管,了解是否有脐静脉的异常连接。结果:2160例胎儿诊断永久性右脐静脉5例,均与静脉导管正常连接,未发现其它部位畸形,出生后2～6月随访,脐静脉闭合良好,生长发育未见异常。结论:彩色多普勒超声是胎儿永久性右脐静脉产前诊断的有效方法,无合并其它部位畸形,预后良好。     

经腹和经阴道彩超联合技术对重型α-地中海贫血胎儿的产前早期诊断

目的 探讨经腹和经阴道彩超联合技术对重型α-地中海贫血胎儿的早期产前诊断的效果。 方法 选取我院妇产科门诊2014年12月~2017年12月收治的产检的孕12~26周孕妇153例,采用经腹羊水穿刺术或绒毛膜穿刺术对胎儿进行α-地中海贫血诊断,同时采用腹部联合阴道彩色超声技术对其进行检查,对比两次诊断结果。 结果 经腹部和阴道彩色超声联合技术对重型α-地中海贫血胎儿检测灵敏度为98.96%（95/96）,假阳性率为1.04%（1/96）,特异度为92.98%（53/57）,假阴性率为7.02%（4/57）。在超声图像中可清楚的看到患病胎儿浆膜腔积液、心脏增大、心胸比增大的现象,并且有颈部透明层增厚,肠管回声增强,胎盘增厚等现象。 结论 将经腹和经阴道彩超联合技术运用于早期产前诊断,能较准确的诊断出重型α-地中海贫血胎儿,值得临床的推广应用。       

彩色多普勒超声系统筛查诊断胎儿畸形

目的探讨彩色多普勒超声系统筛查诊断胎儿畸形的价值。方法对11700例孕18~36周的孕妇常规进行彩色多普勒超声筛查,对畸形胎儿进行诊断。结果11700例胎儿,超声筛查诊断胎儿畸形230例,漏诊13例;产后(引产后或出生后)证实畸形243例。结论彩色多普勒超声系统筛查可以较清晰地显示胎儿形态结构,是产前筛查、诊断胎儿畸形的重要手段,对提高出生人口素质具有十分重要的意义。     

Anomalies of the fetal aortic arch: a novel sonographic approach to in-utero diagnosis.

OBJECTIVE: To describe a novel, sonographic approach for in-utero evaluation of normal and abnormal aortic arch. METHODS: Aortic arch was evaluated by imaging of the axial view of the upper fetal mediastinum. The normal left aortic arch was defined by the V-shaped appearance of the junction between the ductus arteriosus and aortic arch, with the trachea situated posteriorly. Right and double aortic arches were diagnosed when the great vessels appeared U-shaped, with intermediate location of the trachea. RESULTS: Between 1997 and 1999, 18 347 women were scanned in three prenatal centers, and pathological findings were prospectively recorded. In a retrospective analysis of the records, we identified 19 fetuses (0.1%) with atypical, U-shaped appearance, and no other structural abnormalities present. With the exception of one fetus with a ventricular septal defect, no congenital cardiac defects were present. Right aortic arch was found in 18 cases, while color Doppler made it possible to diagnose one case with double aortic arch, and one fetus was demonstrated as having Kommerell's diverticulum. In all 18 cases, a left descending aorta and left ductus arteriosus were present, the latter coursing to the left of the trachea, forming a loose partial vascular ring. All were asymptomatic at birth and early infancy. The fetus with double aortic arch that had a true vascular ring underwent early infantile correction. CONCLUSIONS: It is possible to diagnose right and double fetal aortic arch using prenatal ultrasound. The use of color Doppler facilitated in-utero evaluation of possible complications, such as true vascular ring.     

胎儿脐动脉超声血流分型对单绒毛膜双胎妊娠sIUGR预后的影响

目的探讨胎儿脐动脉超声血流分型对单绒毛膜双胎妊娠选择性宫内生长受限预后的影响.方法将91例羊绒毛膜双胎妊娠选择性宫内生长受限孕妇设为试验组,选取同期来我院就诊的正常双胎妊娠产妇31例设为对照组.两组均予以彩色多普勒超声诊断仪进行超声检查,记录两组胎儿预后和妊娠结局,比较不同预后单绒毛膜双胎妊娠选择性宫内生长受限胎儿的超声指标.结果试验组小胎儿宫内死亡率显著高于对照组(P<0.01);大、小胎儿出生体质量均显著低于对照组(P<0.01).试验组不同选择性宫内生长受限分型两胎儿、小胎儿宫内死亡率比较差异无统计学意义(P>0.05);Ⅱ型小胎儿出生体质量显著低于Ⅰ型和Ⅱ型小胎儿(P<0.05),Ⅰ型与Ⅲ型小胎儿出生体质量比较差异无统计学意义(P>0.05).实验组死亡小胎儿羊水过少、选择性宫内生长受限分型Ⅱ型检出率显著高于存活胎儿(P<0.05或0.01),帆状脐带、双胎体质量差异>25%检出率与存活胎儿比较差异无统计学意义(P>0.05).结论羊水过少及选择性宫内生长受限分型是影响单绒毛膜双胎妊娠选择性宫内生长受限胎儿预后的重要原因,对该类孕妇采用超声检查能够提供较为可靠的临床评价依据.     

Myocardial motion imaging: a new application of power color flow and frequency-based color flow Doppler in fetal echocardiography.

OBJECTIVE: Myocardial motion imaging is a new way of looking at the fetal heart using power color flow and frequency-based color flow Doppler to demonstrate heart wall movement in color. This study set out to assess the value of myocardial motion imaging in fetal echocardiography in a routine clinical setting. DESIGN: In our hospital, all patients at high risk of carrying a fetus with a cardiac abnormality are offered detailed ultrasound scanning, including fetal echocardiography, at 20 weeks' gestation. A prospective study was carried out over a 2-month period and, in addition to conventional fetal echocardiography, myocardial motion imaging was also carried out on all patients, by means of both power color flow and frequency-based color flow Doppler ultrasound. RESULTS: Myocardial motion imaging demonstrated fetal heart wall movement in 26 of the 27 patients. Myocardial motion imaging using power color flow gave a global view of fetal heart wall movement, demonstrating both atrial and ventricular contraction simultaneously. Myocardial motion imaging using frequency-based color flow Doppler demonstrated atrial and ventricular contractions separately. In addition, as the direction of fetal heart wall motion can be color coded, atrial contractions, ventricular relaxation and ventricular contraction were demonstrated, providing a functional assessment of fetal heart wall movement. Two cases of cardiac abnormality were also studied, one case of hypoplastic left heart syndrome and one case of atrioventricular septal defect. In both cases functional information was obtained using myocardial motion imaging, and the technique also highlighted the anatomical defect. CONCLUSIONS: Myocardial motion imaging produces both a global view of fetal cardiac anatomy and a functional assessment of individual chamber contraction in the normal and abnormal heart. It may prove to be a useful adjunct to conventional color flow Doppler assessment of the fetal heart.     

彩超筛查法诊断胎儿畸形

目的探讨彩超综合筛查法在诊断胎儿畸形中的价值。 方法总结常规超声产前检查的妊娠18～40周连续病例5335例中疑诊有胎儿畸形，要求采用彩超筛查法，最后确定诊断的一组产前胎儿畸形声像图特征。 结果5335例胎儿中，经引产或出生后证实的各种畸形73例，彩超综合筛查法检出70例，漏诊3例。 结论彩超筛查法是显示胎儿形态结构及产前筛查胎儿畸形的重要影像诊断方法。     

Prenatal diagnosis of an aneurysm of the vein of Galen with three-dimensional color power angiography.

The prenatal diagnosis of an aneurysm of the vein of Galen has been reported on only a few occasions. This rare arterio-venous fistula is suspected when an intracerebral hypoechoic cyst is found in which blood flow can be demonstrated by Doppler ultrasound. This is one of the few conditions where Doppler ultrasound is critical for the diagnosis. Three-dimensional color power Doppler (3D-CPA) is a recent ultrasound modality which enables the three-dimensional visualization of vessels and which is more readily available than magnetic resonance imaging (MRI) We report a fetus in which an aneurysm of the vein of Galen was detected at 33 weeks' gestation and where the application of 3D-CPA enabled a better understanding of the spatial orientation and course of the dilated vessels. The neonate was successfully treated with coil angiography but subsequently died at 5 months of age from cardiac decompensation. Where fetal malformations involve the vascular system, 3D-CPA appears to be a promising technique.     

帆状胎盘孕妇预后与胎儿脐动脉血流超声参数的关系

  目的  分析帆状胎盘孕妇预后与胎儿脐动脉血流超声参数的关系。  方法  选取2018年10月~2021年10月本院收治的102例帆状胎盘孕妇的临床资料及产前超声检查结果进行回顾性分析,依据产妇妊娠结局情况分为妊娠结局良好组(n=60)和妊娠结局不良组(n=42),并选取同期于本院接受孕检的正常孕妇50例作为对照组。采用脉冲多普勒超声检查测定胎儿脐动脉血流收缩末期峰值流速与舒张末期峰值流速的比值(S/D)及阻力指数。比较各组的S/D比值及阻力指数情况,采用Pearson相关性分析S/D比值、阻力指数与分娩孕周、胎儿出生体质量的关系,采用Spearman相关性分析S/D比值、阻力指数与胎儿不良结局率及产妇产后出血率的关系。  结果  妊娠结局不良组的S/D比值及阻力指数均高于妊娠结局良好组和对照组(P < 0.05)。随着S/D比值及阻力指数的增加,孕妇的分娩孕周越短、胎儿的出生体质量越低,胎儿结局不良率及产妇产后出血率越高(P < 0.05)。进一步相关性分析显示,S/D比值、阻力指数与分娩孕周、胎儿的出生体质量呈反比,与胎儿的结局不良率、产妇产后出血率呈正比(P < 0.05)。  结论  胎儿脐动脉血流超声参数S/D比值、阻力指数与帆状胎盘孕妇预后明显相关,且S/D比值、阻力指数越高,分娩孕周越提前、胎儿的出生体质量越低,胎儿的结局不良率越高。      

超声诊断胎儿宫内发育迟缓方法的探讨

目的 从超声角度寻找对IUGR的可行性宫内诊断和预测,以利于临床诊断和治疗。方法 采用二维超声及多普勒血流法对胎儿进行一些客观数据的测定,如双顶径、头围、腹围、脐带血流速曲线等。结果 9例IUGR患者超声数据均提示PI、RI、s/D增高,其中2例S/D比值分别达6.27和6.87,并有舒张期血液反流现象,出生后1分钟新生儿Apgar’s评分4分。 结论 胎儿脐血流参数的变化(P<0.001)可提示胎盘血流动力学改变并直接影响胎儿导致IUGR的发生;而舒张期血流异常可预测IUGR患者胎儿的预后。     

Color Doppler identification of a pericardial effusion in the fetus.

The aim of the study was to determine whether color Doppler identifies abnormal fluid within the pericardial space of the fetal were referred for heart. Second- and third-trimester fetuses diagnostic ultrasound. The four-chamber view of the fetal heart was imaged with real-time ultrasonography and examined for the presence or absence of separation of the pericardium from the epicardium, which extended from the atrioventricular junction toward the apex of the ventricle. To examine the pericardial space, the color Doppler maximal velocity was set at low Nyquist limits (0.08-0.24 m/s). In each fetus the transducer was angled so that the axis of the interventricular septum was parallel or tangential to the ultrasound beam to optimize the color Doppler recording. The control group consisted of 50 fetuses (16-38 weeks of gestation) who did not demonstrate evidence of pericardial effusion when examined with real-time ultrasound. Second- and third-trimester fetuses were selected from our database who demonstrated a pericardial effusion identified with real-time ultrasound.Color Doppler signals were not identified within the pericardial space in the 50 control fetuses. Fetuses with a pericardial effusion identified with real-time ultrasound demonstrated color Doppler within the pericardial space which was opposite to the direction of blood entering and exiting the ventricles. Color Doppler enhanced the detection of a pericardial effusion in the second-trimester fetus when the axis of the heart was and third-parallel or tangential to the ultrasound beam, which is suboptimal for real-time imaging.Color Doppler provides a new method to identify a pericardial effusion in the fetus during the second and third trimesters of pregnancy and complements the real-time examination.     

胎儿双侧锁骨下动脉切面在迷走右锁骨下动脉诊断中的应用价值

目的探究胎儿双侧锁骨下动脉切面在迷走右锁骨下动脉(ARSA)诊断中的应用价值。方法选择2018年4月至2019年4月入院接受胎儿心脏超声检查的978例孕妇为研究对象,采用彩色多普勒超声诊断仪观察胎儿三血管气管切面(3-VT)和双侧锁骨下动脉切面。统计孕妇产前超声检查结果中的ARSA检出情况。结果978例胎儿中3-VT切面异常者20例,包括6例ARSA、2例主动脉弓缩窄、2例法洛氏四联症、2例永存动脉干、1例右心发育不良、1例单心室、6例永存左上腔。双侧锁骨下动脉切面ARSA检出率为0.72%(7/978),其中6例与3-VT切面诊断结果一致,1例被3-VT切面扫查漏检。结论双侧锁骨下动脉切面可清晰显示左、右锁骨下动脉及其与左、右无名静脉、气管的位置关系,有助于提高产前ARSA检出率,预防严重畸形儿出生。     

胎儿鼻泪管囊肿的产前超声诊断

目的 探讨胎儿鼻泪管囊肿的产前二维及三维超声声像图特征.方法 采用二维及三维超声对29例鼻泪管囊肿胎儿行产前连续顺序超声检查,重点对双侧眼眶横切面超声图像特征进行观察,并与引产及产后临床随访结果进行比较,总结鼻泪管囊肿产前超声声像图特征.结果 胎儿鼻泪管囊肿主要声像图特征是眼眶鼻侧下方呈类圆形无回声区,内径<15 mm,边界清,壁较光滑,内透声好.29例鼻泪管囊肿胎儿产前超声表现:二维超声显示单侧鼻泪管囊肿22例(左侧12例,右侧10例),双侧鼻泪管囊肿7例;囊肿大小4～13 mm,平均(7.69±2.25) mm.囊肿边界清,壁较光滑,内透声好;其中20例眼眶鼻侧下方呈类圆形无回声区,9例内分泌物沉积囊内形成稍高回声团.CDFI:29例鼻泪管囊肿内均未见明显彩色血流信号.三维超声均可直观显示29例鼻泪管囊肿,表现为眼眶鼻侧囊性无回声区及眼眶鼻侧皮肤局部隆起.产前超声诊断胎儿鼻泪管囊肿28例(28/29),误诊1例(产前二维超声诊断为鼻泪管囊肿,出生后证实为眼眶皮样囊肿).29例胎儿临床复查和产后随访结果:(1)孕31～36周超声复查4例胎儿鼻泪管囊肿消失.(2)2例引产儿中1例鼻泪管囊肿合并室间隔缺损及脐动脉腹内段走行异常,1例鼻泪管囊肿合并唇腭裂.(3)19例(19/29)出生后可见鼻泪管囊肿,囊肿部位及侧别与产前超声检查结果相符合.结论 产前二维及三维超声能较好显示胎儿鼻泪管囊肿,并能动态监测其转归,是诊断胎儿鼻泪管囊肿首选方法.     

胎儿颅内出血的产前超声特征与妊娠结局

目的探讨胎儿颅内出血的产前超声声像图特征.方法对30例颅内出血胎儿产前及产后颅脑超声声像图进行对照分析.结果30例颅内出血胎儿超声声像图特征:(1)颅内异常回声特征:30例均显示颅内异常占位回声(双侧异常回声14例,单侧异常回声16例),但出血量、出血时间不同异常回声表现不同;其中15例(15/30,新鲜出血期)颅内出血区呈高回声,11例(部分液化期)颅内出血区呈混合性回声,4例(完全液化期)颅内出血区呈囊性无回声.(2)异常回声区边界及血流特征:异常回声区边界清晰,彩色多普勒血流成像示异常回声区内部及周边未见明显彩色血流信号.(3)超声分级诊断与随访结果:超声诊断Ⅰ级颅内出血17例(均为室管膜下出血),表现为单侧或双侧室管膜下高回声区、混合性回声区或囊性无回声区,大小3~21 mm,双侧侧脑室无扩张(侧脑室宽度均<15 mm);胎儿预后较好,颅脑超声随访(12例)均证实为颅内出血,引产1例,失访4例.Ⅱ级颅内出血5例,均无脑室扩张,单侧或双侧侧脑室内高回声区,大小8~28 mm,与脉络丛分界尚清,双侧侧脑室无扩张(侧脑室宽度均<15 mm);产后颅脑超声随访证实2例为颅内出血,引产2例,失访1例.Ⅲ级颅内出血6例,脑室内出血合并脑室扩张,单侧或双侧脑室内呈高回声或混合性回声区(单侧或双侧侧脑室宽度≥15 mm);胎儿MRI诊断颅内出血1例,引产5例,失访1例.Ⅳ级颅内出血2例(双胎1例),Ⅰ~Ⅲ级脑出血合并脑室周围实质内大范围出血,脑室周围实质呈高回声或混合性回声区;胎儿MRI诊断颅内出血1例,2例均引产(1例双胎之一胎死宫内).(4)颅内出血合并异常:合并宫内发育迟缓5例,胎盘异常3例,羊水异常3例.(5)临床结局:14例临床预后较好(Ⅰ级12例,Ⅱ级2例),产后新生儿存活,无严重神经系统并发症;引产10例预后均较差(Ⅰ级1例,Ⅱ级2例,Ⅲ级5例,Ⅳ级2例),失访6例.结论胎儿颅内出血产前超声表现为颅内异常占位回声区,回声边界清晰,其内无血流信号,超声分级诊断有助于判断胎儿颅内出血严重程度,可估测胎儿预后和协助产前咨询.     

胎儿卵巢囊肿产前超声图像特点及预后评估

目的 探讨胎儿卵巢囊肿产前超声声像图特点及预后评估.方法 对2015年1月至2019年12月北京市海淀区妇幼保健院产前超声诊断的19例胎儿卵巢囊肿检出时的胎龄、大小及回声变化特点进行回顾性分析,总结其预后.结果 12例单纯型囊肿和4例复杂型囊肿大小变化符合缩小趋势.18例胎儿卵巢囊肿长径均在30～33周达到最大值.除1...