中孕早期胎儿梅干腹综合征超声图像分析

Imaging analysis of ultrasound in the diagnosis of Prune belly syndrome during the early second-trimester

目的探讨中孕早期梅干腹综合征(PBS)胎儿超声声像图特征。方法对2014年1月至2017年3月在中国医科大学附属盛京医院产前超声诊断提示为PBS的16例单胎妊娠胎儿超声声像图特征及尸检结果进行对照分析。结果 16例PBS胎儿产前超声均表现为腹壁菲薄,膀胱巨大,其中5例合并其他系统畸形,包括单脐动脉2例,骶尾部畸胎瘤1例,脊柱裂1例,足内翻1例。超声检查后16例孕妇均选择终止妊娠,胎儿尸检标本及镜下均显示腹壁发育不良,表现为腹壁菲薄,腹壁肌纤维部分或全部缺失,胶原纤维增加;腹腔内巨大囊性包块均为增大的膀胱;其中1例PBS合并肛门闭锁,产前超声漏诊合并畸形。结论中孕早期羊水尚未明显减少,此期超声对PBS胎儿及合并畸形显示较清楚,因此诊断较准确。

Objective To investigate the sonographic characteristics of prune belly syndrome(PBS)in early period of second trimester.Methods A total of 16 pregnancies with diagnosis of PBS were enrolled between January 2014 and March 2017.Their sonographic characteristics and autopsy outcomes were analyzed.Results Overdistension of fetal bladder and flimsy fetal abdominal wall were found in all 16 cases.And there were 5 cases found prenatally to be associated with other abnormalities,including single umbilical artery(2 cases),sacrococcygeal teratoma(1 case),spina bifida manifesta(1 case)and strephenopodia(1 case).All women decided to terminatethe pregnancy,and deficiency of the abdominal musculature and increased collagen fiber were found by autopsy.Because of the confusion of the huge bladder,one case associated with imperforate anus was missed by prenatal ultrasonography.Conclusion Prenatal diagnosis of PBS in early period of second trimester is very important,because the amniotic fluid volume is still enough to evaluate the fetal structure.