产前超声诊断先天性膈膨升及漏误诊分析

目的:探讨超声诊断胎儿先天性膈膨升的声像图特征并对漏诊、误诊进行分析.方法:分析2014年1月—2018年12月产前超声诊断先天性膈膨升的10例胎儿病例资料及随访结果,总结其胸腔横切面、冠状面、矢状面的产前超声图像特征,观察双侧膈肌的矛盾运动,并与产前MRI、产后胸片、解剖结果对比分析.结果:10例胎儿膈膨升中右侧6例...

Analysis of diagnosis,missed diagnosis and misdiagnosis of congenital diaphragmatic eventration by prenatal ultrasound

Objective:To evaluate the value of prenatal ultrasound in the diagnosis of fetal congenital diaphragmatic eventration,and analyze the missed diagnosis and misdiagnosis.Methods:Ten cases of fetal congenital diaphragmatic eventration examined by prenatal ultrasound from January 2014 to December 2018 were analyzed,the prenatal ultrasonic features of the disease in thoracic transverse,coronal and sagittal axis were summarized,paradoxical motion of bilateral diaphragmatic was recorded.Antenatal signs were compared with prenatal MRI,postpartum X-ray and autopsy results.The misdiagnosis and missed diagnosis were analyzed.Results:In ten cases of fetal congenital diaphragmatic eventration,six cases were on the right,four cases on the left.Eight cases were correctly diagnosed by prenatal ultrasound,one case was missed,one case of left diaphragmatic hernia was misdiagnosed while confirmed by MRI as congenital diaphragmatic eventration.Six cases were combined with multiple malformations,including three cases of right diaphragmatic eventration and three cases of left.Five cases were associated with hydramnios,two cases combined with single umbilical artery.Three cases of multiple abnormalities were confirmed by pathology,two cases of them were 18-tresomy syndrome.The other seven cases were confirmed by postpartum X-ray.Conclusion:Prenatal ultrasound is the first choice for screening and diagnosis of congenital diaphragmatic eventration,some foetuses with extensive lesions of diaphragmatic or with other thoracic malformation,which are difficult to distinguish from diaphragmatic hernia,could be further evaluated by prenatal MRI.Once fetal diaphragmatic eventration is confirmed,scanning other systems thoroughly.Chromosomal abnormalities should be noted in patients with multiple malformations.