超声诊断胎儿先天性肾脏畸形的价值

目的探讨超声诊断胎儿先天性肾脏畸形的价值。方法对美国加州一产前诊断中心5年中做产科超声的孕妇检查结果进行分析。结果发现各种肾脏形占58例，其中肾发育不全者4例，多囊肾8例，梗阻引起的囊样肾畸形5例，肾与输尿管重复畸形6例，异位肾6例，肾积水18例，染色体隐性遗传的多囊肾疾病3例。染色体显性遗传的多囊肾疾病2例，先天性肾小球功能异常1例，Meckel-Gruber综合征3例，Beckwith-Wiedemann综合征2例。分析各种畸形的声像图特点，不同类型肾畸形有不同声像图表现，并与其胚胎发育过程异常相关。结论泌尿系统畸形对妊娠结果有着重要的影响，特别是伴有羊水过少时，超声能准确地发现和诊断泌尿系畸形，在诊断胎儿先天性肾脏畸形中有重要价值，了解畸形的发生原因，可更好理解其预后，为临床提供准确诊断和处理依据。

Value of ultrasound in the diagnosis of congenital renal malformations

OBJECTIVE: To assess the value of ultrasound in diagnosis of congenital renal malformations. METHODS: The records of obstetric ultrasound examinations were reviewed in all the pregnant women admitted in Alta Bates Perinatal Diagnostic center (Oakland, California, USA) during 5 years. RESULTS: Ultrasound examination identified 58 cases of congenital renal malformations of different kinds, including 4 cases of renal agenesis, 8 multicystic dysplastic kidney, 5 cystic renal dysplasia with obstructions, 6 renal and ureteral duplications, 6 ectopic kidneys, 18 hydronephroses, 3 autosomal recessive polycystic kidney diseases, 2 autosomal dominant polycystic diseases, 1 Finnish-type congenital nephrosis, 3 Meckel-Gruber syndromes, and 2 Beckwith-Wiedemann syndromes. Different renal malformations had different ultrasound findings that correlated to abnormalities in embryonic developments. CONCLUSIONS: Urinary tract abnormalities have a profound effect on pregnancy outcome, especially when associated with oligohydramnios. Many urinary anomalies can be readily detected and diagnosed by ultrasound, which provides a useful modality in diagnosis of fetal congenital renal malformations. Clear understanding of the causes of these abnormalities facilitates prognostic evaluation and clinical decision on the treatment protocol.