胎儿半椎体畸形的产前超声诊断及临床意义

Prenatal ultrasonic manifestation and clinical significance of fetal hemivertebra

目的:探讨半椎体畸形胎儿产前超声声像图表现及其临床意义。方法:对2011年5月—2016年5月于东莞市茶山医院和东莞市石碣医院产前超声诊断并经产后或引产后X线检查证实为半椎体畸形的14例胎儿的产前超声图像进行回顾性分析。结果:在14例半椎体畸形中,单发者6例(胸椎受累4例、腰椎受累2例)、多发者8例(胸椎受累5例、胸腰椎联合受累2例、腰椎受累1例;共19个半椎体,其中产前超声发现17个,产后X线确诊为19个)。单纯性半椎体畸形5例,合并其他系统畸形者9例。其中合并心脏畸形7例(包括2例完全性心内膜垫缺损并右室双出口、1例完全性大动脉转位、1例右室双出口、1例肺动脉闭锁伴室间隔缺损、2例法洛四联症);合并泌尿系统畸形4例(包括多囊性发育不良肾3例、左侧肾缺如1例);合并神经系统畸形2例(包括全前脑1例、小脑隐部缺失1例);合并其他系统畸形12例(10例合并肋骨缺失、2例多指畸形)。结论:胎儿半椎体具有特征性超声表现,半椎体的产前超声筛查对优生优育具有重要的、临床意义。

Objective:To investigate the prenatal ultrasonographic characteristics and their clinical significance of the fetal hemivertebra.Methods:The prenatal ultrasonographic characteristics of14cases of fetal hemivertebrae,which were confirmed by X-ray in Chashan Hospital of Dongguan and Shijie Hospital of Dongguan between May2011and May2016were retrospectively analyzed.Results:Among the14cases of fetal hemivertebra,6cases had single vertebral deformity(4cases in the thoracic spine,4cases in the lumbar spine),8cases had multiple vertebral deformity(5cases in the thoracic spine,2cases both in the thoracic and lumbar spine,1case in the lumbar spine).There were a total of19hemivertebras,in which17were found by prenatal ultrasound but19were found by postpartum X-ray).Besides the vertebral defect,9fetuses had additional anomalies,of which7fetuses had cardiac malformations(2cases of complete endocardial cushion defects and double outlet right ventricle,1case of complete transposition of the great arteries,1case of double outlet right ventricle,1case of pulmonary atresia and ventricular septal defect,2cases of tetralogy of Fallot),4fetuses had urinary tract abnormalities(3cases of polycystic kidney disease,1case of left renal agenesis),2fetuses had central nervous system malformation(1case of holoprosencephaly,1case of absence of the cerebellum),and12fetuses had other abnormalities(10cases of missing ribs,2cases of polydactyly).Conclusion:Hemivertebra has characteristic ultrasonic performance and the prenatal ultrasound of hemivertebra has important clinical significance in eugenics.