彩色多普勒超声与实时三维超声对胎儿腹裂与脐膨出的诊断及鉴别诊断价值

The Value of the Diagnosis and Differential Diagnosis in Gastroschisis and Omphalocele of Fetus with Color Doppler Ultrasound and Real-time Three-dimensional Ultrasound

目的:分析彩色多普勒超声(CDU)及实时三维超声(RT-3DU)对胎儿腹裂与脐膨出的诊断及鉴别方法,评价其临床价值。方法:回顾17例既往在我院彩色多普勒超声及实时三维超声诊断为腹裂、脐膨出,并经引产或随访后证实的病例,根据其声像图特征,总结诊断及鉴别方法,分析易漏诊、误诊的原因。比较超声诊断结果与临床符合率。结果:17例产前彩色多普勒超声及实时三维超声疑为腹壁畸形的病例中,确诊腹裂11例,脐膨出6例。全经引产后及随访证实,诊断符合率达100%。结论:彩超对胎儿腹裂与脐膨出畸形的检出具有安全、无创、方便的特点,可动态、全面、连续观察腹壁病变大小、范围、膨出物特征,具有重要临床应用价值,有利于优生优育,提高新生儿存活率,降低出生缺陷。

Objective To analyze the diagnosis and differential diagnosis of gastroschisis and omphalocele of fetus with Color Doppler Ultrasound(CDU)and Real-time three-dimensional Ultrasound(RT-3DU),and evaluate the clinical value.Methods Seventeen cases were reviewed.They were diagnosed gastroschisis or omphalocele in our hospital with CDU and RT-3DU,confirmed after induction of labor or follow-up.The method and experience of differential diagnosis was summarized according to the image feature.The reason of missed diagnosis and misdiagnosis was analyzed.Also,we can compare the accordance of ultrasound with clinical result.Results Seventeen cases suspected abdominal wall malformations with CDU and RT-3DU,were confirmed as 11 gastroschisis and 6 omphalocele after induction of labor or follow-up,the accordance rate was 100%.Conclusion The CDU and RT-3DU which can be used to observe the abdominal wall lesion size,scope and dilatant characteristics dynamicly,comprehensively and continuously,were safe,noninvasive and convenient method of detecting the gastroschisis and omphalocele of fetus.This method has an important clinical value that conducive birth,improve neonatal survival rate and reduce the birth defect.