产前超声诊断胎儿阴茎阴囊转位

Prenatal ultrasound diagnosis of penoscrotal transposition

目的探讨胎儿阴茎阴囊转位产前超声声像图特征及其诊断价值。方法回顾性分析18胎经产前超声诊断为阴茎阴囊转位的胎儿的超声声像图,探讨胎儿阴茎阴囊转位的产前超声声像图特征。结果 18胎胎儿中,14胎经出生后新生儿检查或引产后胎儿尸检证实为阴茎阴囊转位,1胎为女性假两性畸形,2胎为阴茎短小,1胎于外院引产后失访。超声产前诊断阴茎阴囊转位的准确率为77.78%。本组胎儿阴茎阴囊转位的典型超声图像特征:①胎儿下腹部、会阴部的矢状面扫查示,胎儿外生殖器失去正常结构,阴囊的位置比阴茎高,位于阴茎和脐带进入腹壁的平面之间;②冠状面扫查示阴囊分裂显示为两个阴囊,每个阴囊内可见一睾丸回声;③近足侧的切面显示阴茎位于分裂的两个阴囊中间。结论胎儿阴茎阴囊转位具有特征性的超声表现,掌握其产前超声诊断的主要切面及产前超声声像图特征,对提高产前诊断准确率有重要价值。

Objective To observe the ultrasonic characteristics and their value of antenatal diagnosis of fetal penoscrotal transposition.Methods Ultrasonograms of 18 fetuses diagnosed of penoscrotal transposition with prenatal ultrasound were analyzed,and the characteristics were discussed.Results Of 18 fetuses,14 were proved to have penoscrotal transposition after physical examination or through the autopsy after the induced labor;1 was female pseudohermaphroditism;2 were small penis and 1 was failed to contact because of the induced labor in other hospital.The diagnostic accuracy of prenatal ultrasound was 77.78%.There were some ultrasonic characteristics for fetal penoscrotal transposition in this group.Firstly,on a sagittal scan of the lower abdomen and perineum,the scrotum locating between the penis and the insertion of the umbilical cord into the abdominal wall was higher than the penis in position.Secondly,on an axial scan,the bifid scrotum was shown to be 2 separate scrotal sacs.There was 1 testicle in each separate scrotal sac.Thirdly,a little caudal to the section,the penis located between the bifid scrotal sacs.Conclusion Fetal penoscrotal transposition has some ultrasonic characteristics,which are helpful for increasing the accuracy of prenatal diagnosis of the translocation of penis.