胎儿下颌畸形的产前超声诊断分析

Prenatal ultrasound diagnosis of fetal gnathia malformation

目的探讨胎儿下颌畸形的产前超声表现、检查技巧及临床意义,提高此类畸形的产前检出率。方法对山东省枣庄矿业集团中心医院常规产前筛查或在外院超声检查发现其他异常来我科会诊的胎儿颜面部进行常规多切面扫查。先通过二维超声正中矢状切面主观目测是否存在下颌发育畸形,同时对可疑病例进行颜面部的冠状面及横切面补充扫查,仔细测量下颌骨前后径,并与双顶径进行比较,然后启动三维表面重建成像协助明确产前诊断。所有经产前超声诊断的患者均经引产后证实。结果产前共检出下颌发育畸形胎儿11例,其中小下颌畸形9例,下颌骨缺失2例。结论产前二维超声可以明确诊断胎儿下颌发育畸形,正中矢状切面是诊断此类畸形的首选切面;颜面部三维表面成像具有空间立体显像优势,可全面、直观地再现颜面结构的外形及细部缺陷,是提高胎儿颜面畸形诊断准确度的有效辅助手段。

Objective To investigqte the prenatal ultrasound features,inspection techniques and clinical value of jaw deformity,and to improve the prenatal detection rate of such deformities.Methods Cases suspected fetal jaw deformities were scanned with routine multi-facets of facial scanning such as transverse,coronal and sagittal sections during prenatal ultrasonography.Firstly,a subjective visual of jaw deformities was carries out by a median sagittal sections of two-dimensional ultrasound,and then a coronal and cross-section scanning were added on suspected patients.The diameter of mandibular anteroposterior and bilparietal were measured and compared.Moreover,a three-dimensional surface reconstruction imaging was built for prenatal diagnosis.All cases diagnosed by prenatal ultrasound were confirmed by the induction of labor.Results Eleven cases had prenatal gnathia malformation,of which 9 cases had micrognathia and other 2 cases had mandibular deficiency.Conclusion Prenatal fetal two-dimensiona ultrasound can detect gnathia malformation clearly.Midline sagittal section is the first choice in diagnosing such deformities.Facial three-dimensional surface imaging has an advantage of a spatial three-dimensional imaging delete,which can reproduce the facial shape and detect the detail defects comprehensively and intuitively,so it is an effective supplementary method to improve the diagnostic accuracy of fetal facial malformations.