单纯腭裂的产前二维超声诊断

Prenatal diagnosis of isolate fetal cleft palate by two-dimensional ultrasonography

目的探讨腭的标准切面在单纯腭裂产前超声诊断中的应用价值，总结单纯腭裂的二维超声图像特征。方法对孕龄分布在18--40周18073例胎儿利用二维超声经口裂、经面颊部、经颈侧部扫查胎儿腭结构，获取腭标准的矢状切面、横切面、冠状切面诊断单纯腭裂，并与引产和分娩结果对照分析。结果18073例胎儿中，发现单纯腭裂20例，产前超声检出19例，其中正确诊断18例，误诊1例，漏诊1例；产前超声检出的敏感性为95％，特异性为100％，准确性为95％。单纯腭裂的二维超声图像特征：缺裂均位于中线，软腭裂表现为软腭正中回声中断，缺裂呈“〉〈”、“｜｜”、“／＼”形，硬腭裂表现为硬腭正中回声中断，缺裂呈倒“U”形或倒“V”形。结论腭的标准切面在单纯腭裂的产前超声诊断中具有较高的应用价值，可评估裂隙形态、长度、宽度、走向、累及范围等。

Objective To discussion the value of palate standard section in prenatal ultrasound diagnosis of isolate cleft palate, and summarize the two-dimensional ultrasound characteristics of isolate cleft palate. Methods Two-dimensional ultrasound was performed in 18 073 fetuses during 18 to 40 gestational weeks of pregnancy. Fetal palate structure were scanned through the oral cleft, the cheek, the neck part, and the standard sagittal section,transverse section and coronal section were obtained to diagnosis cleft palate. The results were compared with labour or postpartum findings. Results In 18 073 cases,20 cases of isolate cleft palate,19 cases were diagnosed as fetal isolate cleft palate by prenatal ultrasonography, of which 18 cases were correctly diagnosed, 1 case was misdiagnosed, 1 case was missed diagnosed. The sensitivity, specificity, accuracy of prenatal ultrasound detection were 95%, 100%, 95%, respectively. The ultrasonic characteristics of isolate cleft palate：lack of crack were located in the midline,soft cleft palate was shown as the midline of soft palate interrupted, short of crack was＂〉〈 ＂,＂ ｜｜ ＂, ＂/ ／＂ shape, hard cleft palate was shown as the midline of hard palate interrupted,short of crack was open back ＂V＂ or＂U＂ shape. Conclusions The palate standard section has high value in prenatal ultrasound diagnosis of cleft palate, which can assess fracture morphology, length, width, direction and involving range.