胎儿四肢畸形超声检查方法与技巧

Examination of fetal limb deformities by unltrasound

目的总结胎儿四肢畸形的超声检查方法与技巧。方法对产前超声诊断及引产后证实的29例四肢畸形胎儿的声像图特点及胎儿四肢超声检查方法与技巧进行总结分析。结果超声显示29例胎儿肢体畸形图像清晰,采用逐段有序扫查、把握检查时机,利用胎儿体位变化、多切面观察检出胎儿软骨发育不良7例,左下肢及右手畸形1例,手及足畸形2例,右上肢远端及手缺如1例,桡骨发育不全3例,并指1例,多指2例,右股骨、胫腓骨弯曲1例,左胫腓骨短及足畸形1例,足内翻9例,足外翻1例。其中羊水过多1例;合并其他畸形4例。结论胎儿肌肉骨骼系统畸形及肢体畸形产前超声检查中长骨发育异常较易诊断,四肢远端是检查的难点、重点,易发生漏诊、误诊。超声检查注重方法与技巧的应用有助于提高胎儿肢体畸形的检出率。

Objective To summarize diagnostic methods and techniques of fetal ultrasound for limb deformities. Methods Limbs ultrasonic characteristics of fetal malformation, fetal limb ultrasound examination methods and techniques in a total of diagnosed 29 cases after induced abortion were analyzed by prenatal ultrasound. Results The results showed 29 cases of fetal ultrasound images with clearly limb deformity using piecewise orderly scanning in appropriate time and multi-aspect detection. Seven cases of fetal cartilage dysplasia were observed. There were 1 case of left leg and right hand deformity, 2 cases of hand and foot deformity, 1 case of distal right upper limb and hand absence, 3 cases of radial hypoplasia, 1 case of right femur, tibia and fibula bent, 1 case of the left tibia and fibula, and foot deformity, 9 cases of foot varus, 1 ease of valgus foot. In addition, 1 case of polyhydramnios and 4 cases were combined with other abnormalities. Conclusion The fetal musculoskeletal system abnormalities and limb malformations in prenatal ultrasound diagnosis easier dysplasia of long bones, distal limb is the focus of check difficulty and easy to be misdiagnosed. Ultrasound focuses on the application of methods and techniques, which could improve the detection rate of fetal limb deformities.