侧角度照射技术在胎儿腭三维超声成像中的应用价值

Value of using angled insonation technique in three dimensional ultrasonic imaging of the fetal palate

目的评价侧角度照射技术对胎儿腭的容积数据采集及三维后处理的价值。方法选取孕20～28周进行系统胎儿超声检查的孕妇566例，胎儿颜面部正常并经产后证实。在获取颜面部标准正中矢状切面和侧角度照射的正中矢状切面后分别采集容积数据，使用4D-View软件进行后处理。对1例唇腭裂胎儿采用同样的技术进行容积采集及数据后处理。结果566例胎儿中分别有458例和411例成功采集到标准正中矢状切面及侧角度照射正中矢状切面的容积数据。胎儿原发腭在标准组和侧角度照射组均可很好地重建显示（100％）。标准组中硬腭的轴平面不能重建，只有36％的眙儿硬腭的冠状面和经口裂斜冠切面可重建出，软腭重建的显示率为87％。在侧角度照射组中硬腭轴平面、冠状面及经口裂斜冠切面重建显示率均为100％，软腭重建显示率为82％。1例唇腭裂胎儿可清楚地显示牙槽突裂累及继发腭的情况。结论侧角度照射技术在显示继发腭的基础上采集容积数据，采用三维后处理技术，可获取全部腭任意部位的常规三正交平面及其他任意切面，从而实现对胎儿腭的完整性的评估，对唇裂合并的腭裂进行诊断和分类，并使单纯腭裂的产前诊断成为可能。

Objective To evaluate the value of angled insonation technique in obtaining the volumes of the fetal palate and in three-dimensional post-processing. Methods Five hundred and sixty-six cases of 20 -28 weeks fetuses with normal face were confirmed by systemic ultrasound examinations and post natal examination. The volumes in the standard rnidsagittal plane and angled midsagittal plane were obtained,then post-processed these data by 4D-View software, The same technology was used for volume data acquisition and processing to 1 case of cleft lip and palate fetal. Results In 566 fetuses, two groups of volume data were successfully acquired in 458 cases （standard midsagittal plane group） and 4ll cases （angled midsagittal plane group）. Fetal primary palate in the standard group and the angled group can be both well visualized （100%）. Axial plane of hard palate can not be reconstructed in the standard group. Only 36% of the fetal hard palate＇s coronal plane and transoral oblique coronal plane can be reconstructed. The visualization rate of soft palate was 87 % in the standard group, which was slightly higher than the angled group （82 %）. The visualization rate of hard palate＇s axial plane, coronal plane and transoral oblique coronal plane was 100% respectively in the angled group. Cleft alveolar process involving the secondary palate can be clearly visualized in I case of cleft lip and palate fetus. Conclusions By using the angled insonation technique,which is based on clearly visualizing secondary palate to obtain volumes, using three-dimensional post-processing technique can obtain the conventional three orthogonal planes and any other section of the whole palate. By using it we can assess the integrity of fetal palate,diagnose cleft lip with or without cleft palate and classify the cleft palate, even make prenatal diagnosis of the isolated cleft palate possible.