B超测量胎肝右叶纵径监测胎儿生长受限

Ultrasonographic measurement of longitudinal liver length of growth-restricted fetus

目的 建立不同孕周正常胎儿肝脏右叶纵径指标，观察胎儿生长受限、治疗前后胎儿肝脏右叶纵径的变化。方法 采用超声诊断仪分别测量妊娠18～42周的1106例正常胎儿及64例胎儿生长受限的妊娠妇女治疗前后胎儿的肝脏右叶纵径长度。结果 ①正常妊娠胎儿肝脏右叶纵径与孕周密切相关，孕28周前胎儿肝脏右叶纵径增长速度为每周1，01mm，孕28周后增长速度为每周1.66mm，两者有显著性差异（P〈0.05）；②胎儿生长受限治疗前后胎儿肝脏右叶纵径增长速度为每周1．21mm和1.52mm；③临产前LL和胎儿体重密切相关（r=0.93，P〈0.05）。胎儿肝脏右叶纵径对正常胎儿体重、胎儿发育受限诊断的敏感性分别是88％、87％，特异性分别是89％、91％。结论 胎儿肝脏右叶纵径变化可反映胎儿的宫内生长情况，动态测量可正确评价胎儿宫内生长情况。

Objective To measure fatal liver length in different stages of pregnancy by B-mode ultrasonography and to primarily evaluate predicting value of fetal liver length for growth restricted fetus, Methods The length of right lobe of fetal liver was measured by means of ultrasound at 18 -42 weeks of gestational age among 1106 normal fetuses and 64 growth restricted fetuses before and after treatment. Results （1） The longitudinal length of liver of normal fetuses was closely correlated with gestational age of the fetus, Fetal liver length increased at 1.01mm per week before 28 weeks of gestational age and at 1.66 mm per week after 28 weeks of gestational age, and there was significant difference （P 〈 0.05 ） ; （2）Before and after treatment, the length of liver length of growth restricted fetuses increased at 1,21mm and 1.52 mm per week, respectively; （3） Before parturition, the liver longitudinal length of the fetus was associated closely with his/her birth weight （ r = 0. 93, P 〈 0.05 ）. The sensitivity of ultrasonographic measurement of fetal longitudinal liver length for prediction of birth weight of normal fetuses was 88% and 87% for diagnosis of fetal growth restriction. The specificity were 89% and 91% , respectively. Conclusion Changes in measurement of fetal longitudinal liver length can reflect the growth status of fetus. So, dynamic measurement of fetal longitudinal liver length can accurately evaluate intrauterine growth of the fetus.