彩超对胎儿肾积水的诊断及预后分析

Diagnosis and prognosis of fetal hydronephrosis by color Doppler ultrasound

目的探讨彩色超声检查对胎儿肾积水的诊断及预后。方法通过三维彩色多普勒超声诊断仪进行产前检查,发现50例肾盂积水(60只肾),对其超声影像学资料,进行回顾性分析。结果 60只肾,根据肾盂积水分级标准,其中Ⅰ级36只、Ⅱ级14只、Ⅲ级7只、Ⅳ级2只及Ⅴ级1只。其中,引产Ⅲ级2只,Ⅳ级2只,以及Ⅴ级1只,均在出生后接受手术治疗。肾动脉RI值:肾盂积水Ⅰ～Ⅲ级病例中,肾动脉RI值均小于0.7;而Ⅳ～Ⅴ级病例中,RI值均大于0.7。单双侧病变与羊水量:40例为单侧肾积水,10例为双侧肾积水,其中单侧肾盂积水者羊水量正常,双侧肾盂积水并且其分级为Ⅲ～Ⅴ级者中,有1例羊水过少。结论彩色多普勒超声检查能够客观、准确地反映肾积水病变情况,有利于胎儿预后的评估。

Objective To explore of color ultrasound in diagnosis and prognosis of fetal hydronephrosis.Methods The ultrasound imaging data of 50 cases of hydronephrosis（60 kidneys） with antenatal examination by three-dimensional color Doppler ultrasonic diagnostic apparatus were retrospectively analyzed.Results Sixty kidneys were divided into level Ⅰ of 36,level Ⅱ of 14,level Ⅲ of 7,level Ⅳ of 2,levelⅤ of 1 according to the grading standards,including odinopoeia Ⅲ of 2,Ⅳ of 2,levelⅤ of 1 which all underwent surgical treatment after birth.Renal artery RI：among the hydronephrosis in class Ⅰ-Ⅲ,renal artery RI values were less than 0.7,while RI value of patients in Ⅳ-Ⅴ was greater than 0.7.Single bilateral lesions and amniotic fluid volume：among the 50 cases,40 cases were unilateral hydronephrosis,10 cases were bi lateral hydronephrosis,in which the amniotic fluid volume of patients with unilateral hydronephrosis were normal,1 cases of bilateral hydronephrosis and its grading for Ⅲ-Ⅳ were hypamnion.Conclusion Color Doppler ultrasonography can reflect the hydronephrosis lesions objectively,accurately,and is beneficial to the evaluation for the fetal prognosis.