彩色多普勒和二维超声诊断胎儿脐带扭转的临床研究

Study on diagnosis of fetal umbilical cord torsion with color Doppler ultrasound and two-dimensional ultrasound

目的:研究胎儿脐带扭转的二维志像图特征、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1446例晚期妊娠妇女进行二维超声和CDFI。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、麻花或双排对称串状;横、斜切面以“鼠眼样”和“元宝”形,脐带扭转组与无扭转组在胎儿宫内窘迫、羊水污染、剖宫产发生率有显著性差异。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。

Objective:To study and analyze the two-dimensional ultrasoumd image features ,color Doppler flow imaging(CDFI) and systolic/diastolic(S/D)ratio for fetal umbilical cord torsion.Methods:A total of 1446 late-period pregnancy women were deteced 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 acoustictorsion image of umbilical cord and S/D values were recorded and the results were analyzed after delivery.Results:The postive diagnosis rate of the umbilical cord torsion on CDFI was high and 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.Conclusion: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.