彩色多普勒血流超声诊断胎儿脐带绕颈

随着彩色多普勒超声诊断仪的广泛应用,围产期彩色血流显像对诊断胎儿有无脐带绕颈已引起普遍关注。因该项技术可清晰地显示脐血管的行径,如及时发现胎儿脐带绕颈,在产程中医生可采取有效措施,使胎儿安全分娩,避免因脐带绕颈而引起胎儿宫内窘迫,死亡。因此彩色多普勒血流超声诊断脐带绕颈是对产妇、胎儿及其家庭的一项极大的奉献。     

彩色多普勒血流显像对胎儿脐带绕颈诊断作用

目的 探讨彩色多普勒血流显像(CDFI)对胎儿脐带绕颈的诊断价值。方法 选取42例中、晚期孕妇进行CDFI检查，并与分娩时胎儿的脐带绕颈情况进行对照分析。结果 42例孕妇分娩时有12例胎儿出现脐带绕颈，而产前彩超诊断有胎儿脐带绕颈13例，其正确诊断率为84．6％，假阳性率为7．7％，假阴性率7．7％。结论 彩超对胎儿脐带绕颈有很重要的诊断价值。     

彩色多普勒超声诊断胎儿脐带绕颈26例

目的：探讨彩色多普勒诊断胎儿脐带绕颈的血流改变及具临床应用价值。方法：对26例胎儿脐带绕颈的彩色血流图像改变进行分析。结果：26例胎儿脐带绕颈中,绕颈一周18例,二周6例,三周2例,均经剖宫产术及助产分娩证实,诊断符合率100％。结论：彩色多普勒诊断脐带绕颈弥补了二维超声诊断的不足之处,提高了诊断率。为产科医师观察产程,选择分娩方式,提供了可靠依据,具有较高的临床应用价值。     

彩色多普勒超声诊断脐带绕颈的临床价值

目的 探讨彩色多普勒超声诊断脐带绕颈的临床价值。方法 对比晚孕脐带绕颈者与未绕颈者脐血流情况。结果晚孕脐带未绕颈者或绕颈过松者脐动脉阻力指数(RI)、最大收缩期流速／舒末流速(A／B)值无明显变化。晚孕脐带绕颈中绕颈过紧者脐动脉RI、A／B值增加。结论彩色多普勒超声为临床诊断脐带绕颈提供了有价值的血流动力学依据，值得临床推广应用。     

彩色多普勒血流显像在胎儿脐带绕颈中的诊断价值

目的探讨彩色多普勒超声血流显像在胎儿脐带绕颈中的诊断价值。方法采用彩色多普勒超声诊断仪，检查135例孕妇，孕28-42周，常规先B型超声检查胎儿、胎盘、脐带、羊水等一般情况，再重点观察有无脐带绕颈征象，然后采用彩色多普勒超声血流显像，做进一步检查，确定有无脐带绕颈。结果135例孕妇B型超声检查发现129例脐带绕颈，符合率95．56％；彩色多普勒超声血流显像检查发现135例，符合率100％。结论彩色多普勒超声血流显像在胎儿脐带绕颈中有重要诊断价值。     

彩色多普勒超声诊断胎儿脐带绕颈107例分析

本文对 10 7例脐带绕颈 (ＵＣＡＮ)进行彩色多普勒血流显像检查 ,并与分娩结果进行对照分析 ,旨在探讨彩超对ＵＣＡＮ的诊断价值。资料与方法本组 10 7例为 2 0 0 0年 8月～ 2 0 0 2年 4月期间我院住院分娩的孕妇 ,年龄 2 1～ 38岁 ,平均年龄 2 5岁。孕 37～ 42周 ,平均孕 40周。于产前 3周内行彩超检查 ,使用东芝ＳＳＡ -34 0Ａ彩色多普勒超声诊断仪 ,探头频率 3.5ＭＨｚ。受检孕妇取仰卧位 ,二维超声行产科常规超声检查 ,观察胎儿、羊水、胎盘、脐带等情况 ,并着重观察胎儿颈部 ,注意有无脐带绕颈 ;然后行彩色多普勒及脉冲多普勒检测 ,测…     

彩色多普勒超声诊断胎儿脐带绕颈的临床价值

目的 探讨彩多普勒超声诊断胎儿脐带绕颈的临床价值。方法 根据彩色多普勒超声对620例胎儿脐带绕颈的观察。分析脐带缠绕方式,缠绕周数并观测脐带动脉的血流速度和胎盘阻力指数S/D值,并与分娩结果对比。结果 随着孕周的增加,彩色多普勒超声诊断胎儿脐带绕颈的敏感性上升,35w-待产前、28-34W、20-27W敏感性分别为97.1%、93.0%、62.8%,脐动脉S/D值能够估价胎盘血管阻力和预测胎儿的预后,结论 彩色多普勒超声在诊断胎儿脐带绕颈中起了重要作用。     

彩色多普勒超声检查诊断胎儿脐带绕颈

目的分析彩色多普勒超声检查在诊断胎儿脐带绕颈中的价值。方法报告65例疑诊胎儿脐带绕颈产前孕妇的彩色多普勒超声检查结果，描述了脐带绕颈的声像图特点，并将检出结果与分娩后临床资料进行对比。结果彩色多普勒超声诊断脐带绕颈的准确率较B超明显提高；绕颈组的胎儿宫内窘迫发生率较无绕颈组高，二者差异有显著性（P〈0.05）；绕颈紧密组脐动脉血流速度V5／Vd值、RI值（x±s）较无绕颈组高，二者差异有显著性（P〈0.05）。结论彩色多普勒超声是产前诊断胎儿脐带绕颈的准确方法，并能为临床预测胎儿宫内窘迫提供可靠依据，脐动脉V5／VD值、RJ值检测对于提示脐带缠绕程度及预测胎儿预后有重要意义。     

彩色多普勒超声诊断胎儿脐带绕颈

本文应用彩色多普勒超声对162例孕妇胎儿脐带情况进行了检查,描述了脐带绕颈的声象图特点,分析了脐带绕颈与分娩方式、胎儿预后的关系。其中确诊脐带绕颈98例,诊断准确率为95.7％,敏感性为98％,特异性为91.9％。认为彩色多普勒超声是诊断胎儿脐带绕颈的准确方法。     

胎儿脐带绕颈的4251例彩色多普勒超声诊断

目的应用彩色多普勒超声诊断脐带绕颈,从而探讨彩色多普勒超声诊断胎儿脐带绕颈的准确率,分析误诊原因,对其临床诊断、治疗及分娩方式提供依据。方法应用彩色多普勒对18 269例孕妇产前超声检查检出脐带绕颈与胎儿分娩后结果进行对照分析。结果本院12 869名孕妇产前检查,分娩后脐带绕颈者4 530例,占分娩总数的24.80%,超声诊断脐带绕颈4 251例,诊断准确率93.84%。结论彩色多普勒超声对胎儿脐带绕颈诊断安全、可靠,准确率高,具有相当重要的价值。为临床选择分娩方式及降低围产儿病死率提供了可靠的依据,具有积极的指导意义。     

彩色多普勒对脐绕颈胎儿脐动脉及大脑中动脉血流检测分析

目的　分析脐绕颈胎儿脐动脉 (UA)及大脑中动脉 (MCA)的血流参数 ,为临床判断胎儿脑供血情况提供客观依据。方法　比较 44例脐绕颈剖腹产胎儿与 61例脐绕颈自然分娩胎儿的脐动脉及大脑中动脉血流多普勒参数 ,以RI及VP为分析指标。结果　该两组脐绕颈胎儿UA的RI及VP有显著性差异 ,MCA的RI有显著性差异 ,剖腹产胎儿MCA的血流特点为阻力增高 (RI 0 67± 0 0 2 )。结论　脐绕颈胎儿MCA的血流阻力增高 (RI >0 65 )应作为剖腹产术的临床参考指标     

Prenatal color Doppler sonographic evaluation of nuchal encirclement by the umbilical cord

PURPOSE: The aim of this study was to assess whether Doppler flow velocimetry of the fetal middle cerebral and umbilical arteries is affected by nuchal encirclement by the umbilical cord (nuchal cord) in the prenatal period. PATIENTS AND METHODS: The position of the fetal umbilical cord was assessed on color Doppler sonography in pregnant women who were referred to our radiology department between September 14, 1998, and January 14, 2000. Pulsatility and resistance indices and the ratio of peak systolic blood flow velocity to diastolic velocity of the umbilical arteries and middle cerebral arteries of all fetuses were prospectively obtained with Doppler flow velocimetry. The fetuses were categorized into 2 groups: group 1 consisted of fetuses without sonographic evidence of nuchal cord and group 2 of fetuses with sonographic evidence of nuchal cord. The results were statistically analyzed with independent-groups t test. A p value of less than 0.05 was considered significant. RESULTS: During the study period, 230 pregnant women underwent sonographic examination of the fetus, and 68 fetuses were delivered. The sonographic examinations were performed at 24-41 weeks' menstrual age. Of the 46 fetuses in group 1, 1 fetus had nuchal cord at delivery; of the 22 fetuses in group 2, 4 did not have nuchal cord at delivery. The sensitivity of color Doppler sonography in detecting nuchal cord was 95% (18 of 19 fetuses), the specificity was 92% (45 of 49), the negative predictive value was 98% (45 of 46), and the positive predictive value was 82% (18 of 22). No statistically significant differences in middle cerebral artery or umbilical artery Doppler flow velocimetry values were detected between the 2 groups. CONCLUSIONS: Color Doppler sonography is a sensitive and specific method of diagnosing nuchal cord, but fetal middle cerebral artery and umbilical artery Doppler flow velocimetry values are not affected by the presence of nuchal cord in the prenatal period.     

脐带绕颈胎儿脐动脉及大脑中动脉超声血流参数的特点及与胎儿宫内窘迫的相关性分析

目的 探讨脐带绕颈胎儿脐动脉(UA)及大脑中动脉(MCA)超声血流参数的特点及与胎儿宫内窘迫的相关性.方法 将106例胎儿脐带绕颈孕妇、100例正常孕妇分别纳入脐带绕颈组、非脐带绕颈组.根据不同孕周、是否发生胎儿宫内窘迫对脐带绕颈组孕妇进行再次分组,分别为28～36周组(52例)、≥37周组(54例);宫内窘迫组(28...     

胎儿脐带绕颈的MRI、彩超及分娩结果的对照研究

目的:探讨磁共振成像(MRI)及彩色多普勒血流显像(CDFI)对脐带绕颈诊断价值。材料和方法:对48例中、晚期孕妇进行磁共振成像及彩超对照,并和分娩时胎儿的脐带状况作对照分析。结果:48例胎儿出生时,14例脐带绕颈被发现。其CDFI表现均为胎儿颈部红蓝相间的螺旋状脐血管;产前彩超诊为脐带绕颈者14例,其正确诊断率为92.8%,假阳性率7.1%,漏诊率7.1%。脐带绕颈的典型MRI表现为T1和T2加权图像上,呈类圆形或“品”字形低信号结节。产前MRI诊为脐带绕颈者13例,其正确诊断率为85.7%,假阳性率7.1%,漏诊率14.2%。结论:彩超及磁共振成像能较好地揭示胎儿脐带绕颈。     

脐带绕颈婴幼儿发育商分析

目的 探讨脐带绕颈对婴幼儿发育商的影响.方法 利用盖泽尔发育诊断量表对60例3岁以下脐带绕颈婴幼儿进行智力测评,并对结果进行分析.结果 脐带绕颈的婴幼儿发育商水平普遍低于同龄儿,以轻中度发育迟缓为主.男女婴幼儿之间的发育商比较无显著差异,父母认知与婴幼儿实际的发育商比较有显著差异.结论 脐带绕颈对婴幼儿智力发育有一定影响.应加强健康教育,关注脐带绕颈婴幼儿,并对其进行定期智力监测,早期发现发育迟缓,及时康复训练指导,减少智残的发生.

Abstract：

Objective To investigate the impact of umbilical cord around the neck(UCAN) on infants developmental quotient. Methods Intelligence of 60 infants of UCAN under 3 years old were tested by Gesell. Results DQ of UCAN infants was significantly less than normal infants,mainly mild to moderate retardation. DQ between the male and female infants had no significant difference, parents' cognitive level had significant difference with real DQ of infants. Conclusions UCAN has certain influence on mental development of infants,we should strengthen health education,pay close attention to UCAN infants,give regular intelligence surveillance, find early growth retardation,give rehabilitation training to reduce the incidence of intellectual disabilities.     

彩色多普勒超声诊断胎儿脐带绕颈类型的探讨

目的 应用彩色多普勒超声检测胎儿脐动脉血流参数,对胎儿脐带绕颈进行分裂,以此严格掌握分娩方式,从而降低临床剖宫产率。方法 选择足月妊娠待产者,检测产前１～３ｄ内的胎儿脐动脉血流,对６２例有脐带绕颈与５０例无脐带绕颈胎儿脐动脉血流参数,包括阻力指数（ＲＩ）、收缩期最大血流速度与舒张末期最小血流速度比值（Ｓ／Ｄ）进行对比观察分析,并对其进行松绕与紧绕的分型。结果 ＲＩ、Ｓ／Ｄ在脐带绕颈松绕型与无脐带绕颈组差异无显著性意义（Ｐ〉０．０５）,而紧绕型组与上述两组差异有显著性意义（Ｐ〈０．００１）。脐带绕颈在产程中致胎儿宫内窘迫者在４９例松绕型组有６例,１３例紧张绕型组有７例。结论 应用彩色多普勒超声检测脐动脉血流参数,观察脐带绕颈的分型,特别是临产前连续１～３ｄ内检出的紧绕型脐带绕颈,可做为剖宫产的指征,对产科临床分娩     

High-frequency color Doppler ultrasonography of the spermatic cord arteries: resistive index variation in a cohort of 51 healthy men.

OBJECTIVE: The purpose of this study was to determine the normal range of Doppler ultrasonographic measurements of spermatic cord arteries in a cohort of healthy men. METHODS: The spermatic cord arteries of 51 men were interrogated with color Doppler ultrasonography. The resistive index (RI) of each artery was measured for the entire cohort; peak systolic and end-diastolic velocity values were obtained in a smaller subgroup (n = 31). The artery with the lowest RI was labeled A; the other 2 arteries were identified as B and C. RESULTS: Three separate arteries were identified within the spermatic cord in all individuals. The median RI values for arteries A, B, and C were 0.70 (range, 0.48-0.82), 0.84 (0.67-0.90), and 0.84 (0.72-0.92), respectively. One-way analysis of variance showed a significant difference between the mean RIs of arteries A and B (P < .0001) and arteries A and artery C (P < .0001) but not between B and C (P = .49). Peak systolic and end-diastolic velocity values differed significantly between arteries A and B (P < .0001) and arteries A and C (P < .0001) but not between B and C (P = .31). No age effect was shown for the RI measurements of the cohort. CONCLUSIONS: Color Doppler ultrasonography enables the objective quantification of Doppler measurements of arteries within the spermatic cord. Knowledge of the normal range of Doppler measurements for spermatic cord arteries that supply the testes may be a useful adjunct to the assessment of the testes.     

B型与彩色多普勒超声在胎儿脐带绕颈诊断中的价值比较

目的 比较B型与彩色多普勒超声（彩超）在诊断胎儿脐带绕颈中的价值。方法 对产前行常规B超或彩超检查,疑有胎儿脐带绕颈的180例30～41周孕妇的超声检查结果与分娩结果进行对比分析。结果 二种检查法诊断胎儿脐带烧颈的灵敏度、特异度和准确度分别为89.9%与97.1%,64.6%与81.2%与93.3%。结论 在胎儿脐带绕颈的诊断中,彩超的敏感性,特异性和准确性均高于B超。