胎儿小颌畸形的产前超声诊断

Prenatal ultrasonographic evaluation of fetal micrognathia

目的 探讨胎儿小颌畸形的超声特征及临床意义 ,提高此类畸形的产前检出率。方法 对我院常规产前检查或因外院超声发现其他异常来我科超声检查的 13 5 0 0例胎儿进行颜面部冠状、横切及矢状切面扫查 ,通过正中矢状切面和冠状切面主观判断是否存在小颌畸形 ,再多次测量下颌骨前后径并与双顶径比较 ,对因其他畸形引产的 2例小颌畸形亦行模拟宫内超声检查。结果 产前产后共诊断 15例胎儿小颌畸形 ,所有小颌畸形在胎儿颜面部正中矢状切面及冠状切面显示胎儿下颌短小后缩 ,上下唇不能闭合 ,下唇较上唇更靠后 ,下颌骨前后径明显小于 1/2双顶径 ,13例于产前获得小颌畸形的明确诊断 ,所有产前诊断病例均经引产证实。结论 产前二维超声能诊断胎儿小颌畸形 ,正中矢状切面是诊断胎儿小颌畸形的最佳切面 ,颜面部冠状切面亦有重要作用。由于小颌畸形可能是染色体异常和一些畸形综合征的一个线索和标志 ,因此诊断下颌畸形具有重要临床意义。

Objective To review the prenatal ultrasound features and clinical value of fetal micrognathia.Methods All 13 500 cases were scanned for fetal faces with routine transverse,coronal and sagittal planes during prenatal ultrasonography.Results Thirteen cases with micrognathia were detected by prenatal ultrasonography.Midsagittal and coronal scans of all fetuses with micrognathia demonstrated small mandible and receding chin and the lower lip reside posterior to the upper lip.All prenatal diagnosed fetuses micrognathia were confirmed by autopsy.Conclusions Prenatal ultrasonic diagnosis of fetal micrognathia relied on subjective evaluation of fetal profile on a midline sagittal and a coronal scan of fetal face.Micrognathia may be a clue or marker of chromosomal anomalies and syndrome.Prenatal detecting of micrognathia has important clinical value.