胎儿肾积水及肾脏囊性病变的超声诊断及鉴别诊断

目的：探讨超声对胎儿肾积水及肾脏各种囊性病变诊断及鉴别诊断的价值。材料与方法：应用常规产前超声检查，发现合并胎儿肾脏异常者，仔细观察病变肾脏的大小、形态、内部回声特点、肾盏情况、有无正常肾组织，病变的部位、大小、形态特征、彩色血流分布情况等。同时仔细观察是否合并胎儿输尿管、膀胱异常，羊水异常以及其它胎儿及附属物异常。结果：2006年3月至2009年3月来我院就诊并行超声检查的20532名孕妇中，共发现肾积水72例，重复肾合并肾盂扩张3例，肾囊肿3例，多囊泡肾11例，胎儿型多囊肾5例。上述病例均可经超声明确诊断。结论：不同病理类型的胎儿肾脏囊性病变以及胎儿肾积水，其病因及预后各不相同，因而其诊断及鉴别诊断对于临床处理非常关键。应用产前超声检查，可以对其明确诊断，有效指导临床。

Ultrasound Diagnosis and Differential Diagnosis of Fetal Hydronephrosis and Renal Cystic Diseases

Purpose： To access the value of ultrasound in diagnosis and differential diagnosis of fetal hydmnephresis and renal cystic diseases. Materials and Methods： 20532 pregnant women were examined by ultrasound. If fetal renal abnormality was found, fetus was observed more carefully, including the size, morph, internal echo of the kidney; the character of renal calices; the location, size, internal echo and distribution of color Doppler of the lesion. Meanwhile, careful observation was given to ureter and bladder of the fetus, anmiotie fluid, et al to find the accompanying abnormalities. Results： Of the 20532 pregnant women, fetal hydronephrosis was present in 72 cases and renal duplication with pyelectasis in 3eases, fetal renal cyst in 3case, multicystie kidney dysplasia in 11 cases, infant polycystic kidney in 5 cases. All the cases were diagnosed distinctly with prenatal ultrasound. Conclusion： Fetal hydronephrosis and different pathologic types of renal cystic diseases have different etiopathogenisis and prognosis, so the diagnosis and differential diagnosis is the very key to clinical disposal. Prenatal ultrasonography can diagnosis those diseases accurately and distinctly and give clinical physician effective messages.