实时三维超声与二维超声在检查胎儿畸形中的作用比较

Diagnostic value and the limitations of three dimensional and two dimensional ultrasound for fetal malformations

【目的】初探目前胎儿实时三维超声与二维超声在检查胎儿畸形中的应用价值。【方法】对2173例孕龄7～40周的胎儿进行实时三维超声与二维超声检查,并进行对比分析。【结果】2173例中2139例实时三维超声检查重建面部图像较满意,占98.43%(2139/2173)。胎儿内脏异常图二维超声检查做出诊断46例占2.1%(46/2173)。50例2.3%(50/2139)胎儿体表畸形三维做出明确诊断,二维超声48例2.2%(48/2139),无明显差异(P>0.05),仅有1例胎儿左耳廓畸形,产前实时三维超声与二维超声均未能做出诊断。【结论】胎儿实时三维超声检查图像,直观立体感强,能实时反映胎儿的体表结构及实时动态声像,弥补二维超声立体空间不足,在检查胎儿畸形中有极高的价值,与二维超声相结合,可在检查胎儿畸形中体现出更高临床价值。

[Objective]To evaluate the diagnostic value and the limitations of three dimensional and two dimensional ultrasound for the fetal malformations.[Methods]A total of 2 173 fetuses ranging gestational age between 7～40 weeks were examined with two dimensional and three dimensional ultrasound and followed up after delivery.[Results]Three dimensional ultrasound images were obtained successfully in 2 139 cases（98.43%,2 139/2 173）,but two dimensional ultrasound obtained 46 cases of internal organs malformation（2.1%,46/2 173）.The accuracy of 3D and 2D ultrasonography to diagnose the site of the fetal surface malformations was 2.3%（50/2 139）and 2.2%（48/2 139）respectively and there was no statistical difference between them（P〈0.05）,and only one case of left ear malformation was left out by 2D and 3D ultrasonography.[Conclusion]Three dimensional ultrasound can provide more information in the display of surface structure of fetal face and body and congenital anomaties than two dimensional ultrasound.Three dimensional ultrasound is an important complement to the two dimensional ultrasound and can enhance the detection rate of the fetal malformations when combined with the two dimensional ultrasound.