胎儿胆囊异常的产前超声诊断及意义

Diagnosis and clinicalsignificance of gallbladder anomalies by prenatal ultrasound screening

目的探讨胎儿胆囊异常的产前超声诊断特点和临床意义。方法回顾分析2008年1月至2012年12月中晚孕来我院行超声检查的23 560例孕妇胆囊异常情况、随访胎儿染色体及产后胆囊情况。结果 (1)胎儿胆囊异常率为0.91%,其中胆囊缺如、胆囊增大、胆囊内异常回声胎儿分别占0.69%、0.21%、0.01%;(2)31例超声提示胆囊增大胎儿染色体检查发现整倍体5例,18-三体3例,13-三体1例,染色体异常率为29.03%;(3)3例超声提示胆囊异常回声胎儿,2例在胎儿出生前异常回声消失,1例产后无特殊情况;(4)27例超声提示胆囊缺如胎儿产后出现胆道闭锁7例(25.93%),胆囊增大2例(7.41%),其余均为正常。结论产前超声检查监测胎儿胆囊情况对于及早发现胎儿胆囊异常、染色体异常等具有重要意义,应在产前检查中推广应用。

Objective： To observe the diagnosis trait and clinical significance of detecting gallbladder anomalies by prenatal ultrasound screening. Methods： 23 560 mid -late gravidas taken prenatal ultrasound screening in our hospital from January 2008 to December 2012 were retrospectively analysed. The gallbladder anomalies, fetus chromosome and gallbladder status of post partum were studied. Results： The rate of gallbladder uhasonographic anomalies was 0. 91% , and the rates of non - visualized fetal gallbladder, cholecystomegaly and echogenic materials in fetal gallbladder were 0. 69%, 0. 21%, 0. 01% respectively. Thirty - one cases with cholecystomegaly were performed fetal karyotype analysis. Five cases were euploid, three cases were trisomy 18 and one was trisomy 13. Three cases with echogenic materials in fetal gallbladder, but two of them disappearedantenatally or postnatally. The rest one hasn＇t been performed ultrasonography after birth. Seven of twenty - seven cases with non - visualized fetal gallbladder had biliary atresia, two had cholecystomegaly, and the rest had normal gallbladder. Conclusion ： Detecting fetus gallbladder by prenatal ultrasound screening has a vital role to play in the diagnosis of gallbladder and karyotype anomalies, and consequently it＇s worthy to spread in prenatal uhrasonography continually.