产前超声在评价腭裂骨缺损中的应用

Application of prenatal ultrasonography in evaluating bone defect in palate cleft

目的总结不同类型、程度腭裂骨缺损的胎儿产前超声特征。方法回顾2018年2月至2019年10月在武汉大学人民医院诊断的唇腭裂、单纯腭裂和黏膜下腭裂胎儿上腭的二维和三维图像,对照出生后或引产后结果进行分析。结果产前超声诊断并随访到47例唇腭裂、3例单纯腭裂和2例黏膜下腭裂。牙槽突裂病例中,均可见牙槽突回声中断,97.9%与产后检查相符,完全性牙槽突裂中78.4%可见牙槽错位,89.2%可见鼻中隔。继发腭裂病例中,均可见腭骨水平板强回声带回声中断,88.2%可见鼻中隔,完全继发硬腭裂未见硬软腭的弧形带状回声,部分继发硬腭裂可见短棒状硬腭高回声而未见软腭,而黏膜下腭裂可见硬软腭的弧形带状回声。结论产前结合二维和三维超声,了解牙槽突和继发腭骨缺损的部位、程度和类别,可为产前咨询提供更多信息。

Objective To summarize the prenatal ultrasonic features of different types and degrees of bone defect in cleft palate.Methods The two-dimensional and three-dimensional images of fetuses with cleft lip,cleft palate,or submucous cleft palate diagnosed at our hospital from February 2018 to October 2019 were retrospectively reviewed and compared with the results obtained after birth or termination of pregnancy.Results Prenatal ultrasonography and postnatal follow-up revealed 47 cases of cleft lip and palate,3 cases of isolated cleft palate,and 2 case of submucous cleft palate.The interruption of the alveolar ridge could be detected prenatally in all cleft alveolar cases,in which 97.9%were consistent with the postpartum examination.Approximately 78.4%of the complete cleft alveolar cases showed alveolar dislocation,and 89.2%had the nasal septum.The interruption of the horizontal plate of the band-shaped palate could be detected in all the cases of cleft secondary palate,and 88.2%had the nasal septum.In complete cleft hard palate cases,arc-shaped echoes of the hard and soft palate could not be seen,while short hyperechoic hard palate could be seen without the soft palate in partial cleft hard palate.However,arc-shaped echoes of the hard and soft palate could still be detected in submucosal cleft palate.Conclusion Two-dimensional combined with three-dimensional ultrasound can be used to assess the type and degree of bone defects in cleft alveolus and secondary palate to provide more information for prenatal consultation.