孕中晚期胎儿泌尿系统畸形的超声诊断及临床价值

Ultrasound diagnosis and clinical value of fetal urinary system malformation in middle and late pregnancy

目的探讨孕中晚期胎儿泌尿系统畸形的超声诊断及临床价值。方法选取我院2016年3月-2018年5月妊娠中晚期胎儿泌尿系畸形孕妇60例作为研究对象,回顾性分析胎儿超声表现和随访结果,总结超声诊断及临床价值。结果本组60例胎儿泌尿系统畸形中,梗阻性尿路疾病居胎儿泌尿系统畸形首位,有28例,所占比例为46.67%,其中有14例为单纯肾盂积水,有5例重度肾积水,重复肾积水8例,1例膀胱明显扩张,伴有双侧输尿管及肾盂扩张,其次是肾缺如,有17例,占28.33%,其中有14例单侧肾缺如,3例双侧肾缺如,患侧肾脏图像不能显示,6例异位肾,占10%,为盆腔异位肾,盆腔发现肾脏回声,羊水量正常,9例肾脏囊性疾病,占15%,其中3例是双侧多囊肾,均伴有羊水过少,双侧肾脏呈对称性,回声增强,偶可见小囊结构,单侧多囊性发育不良肾6例,伴发羊水过少或偏多,一侧肾脏明显增大,可观察到大小不一的囊性无回声区,囊与囊之间互不相通,之间可见部分实质回声。超声诊断胎儿泌尿系统畸形的敏感度为96.67%,误漏诊率为8.3%。结论超声作为一种操作简单、重复性好、安全可靠的影像检测手段,可以为临床科学诊断提供依据,可作为孕中晚期胎儿泌尿系统畸形的常规检查手段。

Objective:To investigate the ultrasound diagnosis and clinical value of fetal urinary system malformation in the second trimester. Methods:Sixty pregnant women with urinary tract malformation in the middle and late pregnancy from March 2016 to May 1818 were selected as the research subjects. The fetal ultrasound findings and follow-up results were retrospectively analyzed,and the ultrasound diagnosis and clinical value were summarized. Results:In this group of 60 cases of fetal urinary system malformation,obstructive urinary tract disease was the first in the fetal urinary system malformation,28 cases,accounting for 46.67%,of which 14 cases were simple hydronephrosis,5 cases of severe kidney Hydronephrosis,repeated hydronephrosis in 8 cases,1 case of bladder dilatation,accompanied by bilateral ureter and pyelectasis;followed by kidney deficiency,17 cases,accounting for 28.33%,of which 14 cases of unilateral kidney deficiency,3 For example,bilateral kidney deficiency,the affected kidney image can not be displayed;6 cases of ectopic kidney,accounting for 10%,pelvic ectopic kidney,pelvic cavity found echo,normal amniotic fluid volume;9 cases of renal cystic disease,accounting for 15%,Three of them were bilateral polycystic kidney disease,accompanied by oligohydramnios,bilateral symmetry,echo enhancement,even small cystic structure,unilateral polycystic dysplasia in 6 cases,accompanied by oligohydramnios or More than one side,the kidneys on one side are obviously enlarged,and cystic and non-echo zones of different sizes can be observed. The capsules and the capsules are not connected to each other,and some substantial echoes are visible between them. The sensitivity of ultrasound diagnosis of fetal urinary system malformation was 96.67%,and the rate of misdiagnosis was 8.3%. Conclusion:Ultrasound,as a simple,reproducible,safe and reliable image detection method,can provide a basis for clinical scientific diagnosis,and can be used as a routine examination method for fetal urinary system malformation in the second trimester.