三维超声自由解剖成像技术早期诊断胎儿唇腭裂

Early diagnosis of fetal cleft lip and palate by three-dimensional ultrasonography

目的评价三维超声自由解剖成像(Omni View)技术在早期胎儿唇腭裂中的诊断价值。方法选取我院超声科2017年1月-2018年6月65例疑似唇腭裂的孕妇,孕龄14-18w5例,19-28w60例,应用二维超声和OmniView技术观察继发腭,并与引产或产后对比,比较二维超声和OmniView技术对继发腭裂的诊断符合率;另选取孕14-18w,孕19-28w正常胎儿各50例,应用二维超声及OmniView技术观察继发腭,对比两种技术对于继发腭的显示率。结果 65例中单纯唇裂3例,中央型完全唇腭裂3例,单侧唇腭裂并上牙槽突裂14例,单侧完全性唇腭裂30例,双侧完全性唇裂腭裂15例。14-18w、18-28w应用二维超声继发腭诊断率分别为60%、65%,三维超声OmniView诊断率分别为100%、85%,大大高于二维超声检出率,差异有统计学意义(P<0.05)孕14-18w二维超声硬腭、软腭显示率为76%、58%,三维OmniView技术为94%、80%,明显高于二维超声,差异有统计学意义(P<0.05)。孕18-28wOmniView技术硬腭、软腭显示显示率为88%、78%,二维超声显示率为的80%、66%,差异无统计学意义(P>0.05)。结论 OmniView技术可更直观的显示继发腭,尤其是在中孕早期,应用三维omniview技术可提高严重唇腭裂的诊断率。

Objective:To evaluate the diagnostic value of 3 d ultrasound free anatomical imaging(Omni View)in early fetal cleft lip and palate. Methods:From January 2017 to June 2018,65 cases of pregnant women suspected of cleft lip and palate were selected in the ultrasound department of our hospital,including 5 cases at 14-18 weeks of gestation and 60 cases at 19-28 weeks of gestation. The secondary palate was observed using two-dimensional ultrasound and OmniView technology,and the coincidence rate of diagnosis of secondary palate with two-dimensional ultrasound and OmniView technology was compared with that of induced labor or postpartum. In addition,50 normal fetuses at 14-18 weeks of gestation and 19-28 weeks of gestation were selected to observe the secondary palate with two-dimensional ultrasound and Omni View technology,and the display rates of the secondary palate with the two technologies were compared. Results:Among the 65 cases,there were 3 cases of pure cleft lip,3 cases of complete central cleft lip and palate,14 cases of unilateral cleft lip and palate with upper alveolar cleft,30 cases of unilateral complete cleft lip and palate,and 15 cases of bilateral complete cleft lip and palate. 14 to 18 weeks,18 to 28 weeks application of two-dimensional ultrasound diagnostic secondary palate of 60%,65% respectively,the three dimensional ultrasound Omni View diagnostic rate was 100%,85%,much higher than two-dimensional ultrasound detection rate,the difference has statistics meaning(P<0.05)at 14 to 18 weeks of two-dimensional ultrasound hard palate and soft palate shows at a rate of 76%,58%,3 d O mni View technology for 94%,80%,significantly higher than the two-dimensional ultrasound,the difference was statistically significant(P<0.05). At 18-28 weeks of gestation,the display rate of hard palate and soft palate by Omni View technology was88% and 78%,and the display rate of two-dimensional ultrasound was 80% and 66%,with no statistically significant difference(P>0.05). Conclusion:OmniView technology can more intuitively display the secondary palate,especially in the early pregnancy,the application of three-dimensional OmniView technology can improve the diagnosis rate of severe cleft lip and palate.