胎儿膝关节反屈超声表现

Ultrasonic manifestations of fetal knee flexion

目的观察胎儿膝关节反屈的超声表现。方法回顾性分析15胎膝关节反屈胎儿的产前超声资料,其中14胎于引产后、1胎于分娩后获得明确诊断,观察其产前超声声像图特征。结果15胎中,超声诊断正确12胎,漏诊3胎。膝关节反屈超声表现为胎儿患侧膝关节屈曲方向异常,呈向心性屈曲(即膝关节弯曲时下肢远端肢体向靠近躯干侧运动),受累侧肢体运动受限,无自主屈曲活动。15胎中,7胎膝关节反屈孤立发生,但均合并畸形;8胎为各种综合征的下肢表现,包括2胎Larsen综合征、5胎先天性多发性关节挛缩症及1胎窒息性胸廓发育不良。结论胎儿膝关节反屈超声表现具有一定特征性,有助于产前筛查。

Objective To observe ultrasonic manifestations of fetal knee flexion.Methods Prenatal ultrasound data of 15 fetuses with congenital knee flexion were retrospectively analyzed,and the diagnosis was confirmed after induction of labor(n=14)or delivery(n=1).The prenatal ultrasonic characteristics of fetal knee flexion were observed.Results Among 15 fetuses,12 were correctly diagnosed and 3 were missed diagnosis with prenatal ultrasonography.Fetal knee flexion manifested as the knee joint on the affected side flexed in an abnormal direction during ultrasonic examination,showing centripetal flexing(the distal limb of the lower extremity moved towards the trunk when the knee joint was bent),with limited limb movement on the affected side and without voluntary flexing.Among 15 fetuses,isolated knee flexion was detected in 7 fetuses all combined with other deformities,while 8 were found as lower extremity manifestations of certain syndromes(Larsen syndrome in 2,congenital multiple joint contracture in 5 and aphyxiating thoracic dysplasia in 1 fetus).Conclusion Fetal knee flexion had certain ultrasonic characteristics,which were helpful for prenatal screening.