正常胎儿脾脏及脾动脉超声特征

目的 探讨正常中、晚孕期胎儿脾脏形态及脾动脉血流特点。方法 收集551胎正常中、晚孕期单胎胎儿, 中孕期胎儿分为21~22⁺⁶孕周和23~24⁺⁶孕周组, 晚孕期胎儿分为28~31⁺⁶孕周、32~35⁺⁶孕周和36~40孕周组。产前超声观察胎儿脾脏及脾动脉特征, 测量并比较各组间脾脏及脾动脉各参数差异, 分析各参数与孕周的相关性。结果 99.27%(547/551)胎儿可完整显示脾脏, 其横切面上呈半月形、月牙形或三角形, 呈均匀低回声;脾动脉起自腹腔动脉, 沿胃泡后缘自右向左走行, 经脾门进入脾脏。中孕期23~24⁺⁶孕周胎儿脾脏周长、面积和厚度以及脾动脉收缩期峰值流速(PSV)均大于21~22⁺⁶周胎儿(P均 <0.05), 脾动脉舒张末期血流速度(EDV)和阻力指数(RI)两组差异无统计学意义(P均 >0.05);晚孕期胎儿脾脏周长、面积和厚度及脾动脉PSV和EDV随孕周增加逐渐增加(P均 <0.05), 脾动脉RI无明显改变(P >0.05)。中、晚孕期脾脏周长、面积、厚度、脾动脉PSV以及晚孕期脾动脉EDV与孕周之间呈线性正相关。结论 正常中、晚孕期胎儿脾脏的超声显示率较高, 正常胎儿脾脏超声形态特征及正常参考值范围可为评估相关疾病提供依据。

Ultrosonic characteristics of spleen and splenic artery in nomal fetuses

Objective To explore the characteristics of the spleen morphology and splenic artery flow of normal singleton fetus during the second and third trimester. Methods Totally 551 normal fetuses during the second and third trimester were enrolled and the fetuses during the second trimester were divided into 21-22⁺⁶ and 23-24⁺⁶ gestational week group, the fetuses during the third trimester were divided into 28-31⁺⁶, 32-35⁺⁶ and 36-40 gestational week group. Prenatal ultrosound was performed to observe characteristics of the spleen morphology and splenic artery, the parameters of the spleen and splenic artery were measured and compared among different groups. The correlations between above parameters and gestational week were analyzed. Results Spleens of 99.27% (547/551) fetuses were fully displayed, which was half-moon, a crescent-shaped or triangular, with homogeneous hypoecho on the transverse section of the spleen. The splenic artery orginated from the celiac artery, walking along the trailing edge of the stomach and entering the spleen from the splenic hilum. In fetuses during the second trimester, the circumference, area, thickness of the spleen and the peak systolic velocity (PSV) of the splenic artery in 23-24⁺⁶ gestational week group were all greater than those in 21-22⁺⁶ gestational week group (all P <0.05) and no differences of the end diastolic velocity (EDV) and resistance index (RI) between the two groups were found (both P >0.05). In fetuses during the third trimester, the circumference, area, thickness of the spleen, the PSV and EDV of the splenic artery were increased along with the gestational week (all P <0.05) and RI of the splenic artery kept no change (P >0.05). The circumference, area, thickness of the spleen, the PSV of the splenic artery in fetuses during the second and third trimester and the EDV of the splenic artery in fetuses during the third trimester showed positive linear correlation with pregnancy age. Conclusion The display rate of the spleen of normal fetus during the second and third trimester is high in ultrasound. The ultrasonic morphology characteristics of the normal spleen and reference value range of some parameters may provide a basis for assessment of related diseases in fetus.