三维超声OmniView在妊娠早期诊断鼻骨缺失的临床价值

Clinical value of three-dimensional ultrasound with OmniV iew in the diagnosis of absence of nasal bone in early pregnancye

目的探讨三维超声Omni View在早孕期诊断胎儿鼻骨缺失中的应用价值。方法选取300例早孕期来我院行常规超声检查的孕妇,按胎儿头臀径分为四组,分别为45-54 mm组65例、55-64 mm组74例、65-74 mm组85例、75-84组76例,应用二维及三维超声Omni View对其鼻骨进行观察及图像分析,对比各组间鼻骨的显示率,并重点对鼻骨缺失者进行图像分析。结果 1各组三维超声Omni View对胎儿鼻骨的显示率均高于二维超声,除55-64 mm组（显示率相同）外,各组两者比较差异无统计学意义（P〉0.05）;2三维Omni View对胎儿鼻骨的总显示率稍高于二维超声,但两者比较差异无统计学意义（P〉0.05）。其中6例二维超声在颜面正中矢状面未探及鼻骨,三维超声Omni View可通过颜面部正中矢状面描画解剖线,获取鼻后三角冠状切面和其相垂直的横断切面,显示了胎儿鼻骨。另外7例二维超声及三维Omni View均未显示胎儿鼻骨,诊断为鼻骨缺失。结论三维超声Omni View操作简单,能在二维超声的基础上提供更多鼻骨的诊断信息,减少对操作者技术和经验的依赖,为妊娠早期诊断鼻骨缺失提供了新的思路和方法,是二维超声检查的重要补充。

Objective To investigate the clinical application value of OmniView （a new three-dimensional ultra- sound technology） in the diagnosis of absence of nasal bone in early pregnancy. Methods Three hundred pregnant women who underwent routine ultrasound examination in our hospital were enrolled in the study, which were divided into four groups according to the fetal crown rump length： 45-54 mm （65 cases）, 55-44 mm （74 cases）, 65-74 mm （85 cases）, and 75-84 mm （76 cases）, respectively. The nasal bone was observed and analyzed of by applying two-dimensional ultra- sound and three-dimensional ultrasound with OmniView. The display rates of nasal bone were compared between groups, and the images of absence of the nasal bone were analyzed. Results ① The display rate of each group of OmniView for fetal nasal bone was slightly higher than that of two-dimensional ultrasound （except 55-64 mm group, with the same display rate）, but there was no statistically significant difference （P〉0.05）. ② The total display rate of OmniView on fetal nasal bone was slightly higher than that of two-dimensional ultrasound, with no statistically significant difference （P〉0.05）. For two-dimensional ultrasound, 6 cases does not show the fetal nasal bone in the median sagittal plane on the face. However, for the 6 cases, OmniView can draw the anatomical lines on referenced facial sagittal plane, obtain the retronasal triangle coronal and its perpendicular to the axial plane, then display the fetal nasal bone. Besides, 7 cases did not display the fetal nasal bone in both two-dimensional ultrasound and OmniView, which were diagnosed as nasal bone absence. Condusion Three dimensional ultrasound with OmniView has the advan- tage of simple operation, and can provide more diagnostic information of the nasal bone based on two-dimensional ultrasound, as well as reduce dependence on operator＇s skill and experience. It provides a new idea and method for the early diagnosis of absence of nasal bone and serves as an important supplement of two-dimensional ultrasonography.