二维及彩色多普勒超声诊断胎儿脐带扭转的临床分析

目的研究胎儿脐带扭转的二维声像图特征、彩色多普勒血流显像(CDFI)及脐动脉血流S/D值,分析其临床应用价值。方法对335例晚期妊娠妇女随机进行二维超声和CDFI检查。自脐带胎盘端到胎儿脐轮部循踪行多切面扫查,记录脐带扭转声像,脐动脉血流S/D测值,产后进行对照分析。结果CDFI诊断脐带扭转阳性检出率高,漏诊率低,显著优于二维超声。脐带扭转的声像图特征:纵切面呈绳索、麻花或双排对称串珠状;横、斜切面似“鼠眼样”形和“元宝”形。脐带扭转组胎儿窘迫、低Apgar评分发生率明显高于无扭转组(P<0.05)。结论脐带扭转与胎儿宫内窘迫、预后及分娩方式密切相关。CDFI诊断脐带扭转声像特征更直观、准确。脐动脉血流S/D值可提示胎儿缺氧和预后,有重要临床应用价值。

Two-dimensional and Color Doppler Ultrasound Analysis on Diagnosis of Fetal Umbilical Cord Torsion

Objective To study and analyze the two-dimensional ultrasound image features,color Doppler flow imaging (CDFI) and systolic/diastolic (S/D) ratio for fetal umbilical cord torsion.Methods A total of 335 late-period pregnancy women were detected with two-dimensional ultrasound and CDFI.From the placenta end to the fetal mamipura chakra of the umbilical cord,the multi-section scanning was practiced,by which the acoustic torsion image of umbilical cord and S/D values were recorded and the results were analyzed after delivery.Results The positive diagnosis rate of the umbilical cord torsion on CDFI was high and the missed diagnosis rate was low.CDFI was significantly better than two-dimensional ultrasound.The acoustic image features of the umbilical cord torsion were as follows:In the longitudinal section the cord looked like a rope,a fried dough twist or a symmetric double bank of pinch-and-swell form and,the transverse section and random section looked like a Mickey Mouse and shoe-shaped gold pattern respectively.The fetal respiratory distress and low Apgar value happened in the umbilical cord torsion group were significantly higher than those in the without torsion group (P<0.05).Conclusions The umbilical cord torsion has close association with the fetal respiratory distress,prognosis and delivery ways.The acoustic images of umbilical cord torsion on CDFI is more direct and correct.Moreover the S/D values can show the fetal hypoxia and prognosis is valuable in clinical application.