产前超声诊断胎儿唇腭裂畸形的影像学特征分析

Analysis of imaging features in the prenatal ultrasound diagnosis of fetal cleft lip and palate deformity

目的分析产前超声诊断胎儿唇腭裂畸形的影像学特征。方法3096例产妇作为观察对象,所有产妇均予以产前超声检查,分析胎儿产前超声检查结果、临床随访结局及唇腭裂畸形的影像学特征。结果本次研究3096例胎儿中,经过产前超声检查发生唇腭裂畸形的胎儿共26例,其中单纯性唇裂6例、占比23.08%,左侧唇腭裂12例、占比46.15%,右侧唇腭裂1例、占比3.85%,双侧唇腭裂2例、占比7.69%,中央性唇腭裂3例、占比11.54%,单纯性腭裂1例、占比3.85%,误诊1例、占比3.85%。产前超声诊断26例唇腭裂胎儿中,引产及胎儿出生后证实符合唇腭裂诊断25例,诊断准确率96.15%,误诊1例,误诊率3.85%,漏诊1例。误诊1例:孕23^(+6)周,超声提示:①单纯性腭裂可能性大;②考虑胎儿开放性脊柱裂,引产后证实开放性脊柱裂明确,无单纯性腭裂。另有漏诊1例:为单纯性腭裂,无伴发其他畸形,染色体结果无异常。结论对胎儿进行产前超声检查,能够有效检出其唇腭裂发生情况,值得临床推广应用。

Objective To analyze the imaging features in the prenatal ultrasound diagnosis of cleft lip and palate deformity.Methods 3096 pregnant women were investigated.All pregnant women received the prenatal ultrasound examination.The results of prenatal ultrasound examination,clinical follow-up and imaging features of cleft lip and palate deformity were analyzed.Results Among the 3096 fetuses in the present study,26 fetuses were found with cleft lip and palate in prenatal ultrasound examination,including 6 cases of simple cleft lip,accounting for 23.08%;12 cases of left cleft lip and palate,accounting for 46.15%;1 case of right cleft lip and palate,accounting for 3.85%;2 cases of bilateral cleft lip and palate,accounting for 7.69%;3 cases of central cleft lip and palate,accounting for 11.54%;1 case of simple cleft palate,accounting for 3.85%;and 1 case of misdiagnosis,accounting for 3.85%.Among the 26 fetuses with cleft lip and palate diagnosed by prenatal ultrasound examination,25 cases were confirmed after induced labor and natural birth,and the diagnostic accuracy rate was 96.15%;1 case was misdiagnosed,and the misdiagnosis rate was 3.85%,and 1 case was missed diagnosis.In the misdiagnosed case:23^(+6) weeks of pregnancy,the ultrasound results showed that:①it had high possibility to be simple cleft palate;②the fetus was thought to be possible to have open spina bifida,it was confirmed after induced labor that open spina bifida was clear and there was no simple cleft palate.In addition,1 case was missed diagnosis:it was simple cleft palate without other malformations,and there was no abnormality in chromosome results.Conclusion Prenatal ultrasound examination can effectively detect the occurrence of cleft lip and palate,which is worth of promotion in clinical practices.