彩色多普勒超声在诊断胎儿胆囊异常中的临床研究

Clinical Study of Color Doppler Ultrasound in the Diagnosis of Fetal Gallbladder Abnormalities

目的:探讨彩色多普勒超声在诊断胎儿胆囊异常中的临床效果。方法:选择2017年6月~2019年6月在大连市妇女儿童医疗中心(集团)行胎儿彩色多普勒超声检查的孕妇4300例,对其中46例胎儿胆囊异常进行随访,分析比较产前彩色多普勒超声检查结果与产后复查超声结果,对新生儿追踪6个月以上并判断其预后。结果:正常胎儿胆囊的声像图与成人胆囊声像图相似,表现为经腹部切面时位于肝内段,脐静脉右侧的囊性结构,位置略低于胃泡水平,在横切面及纵切面时分别呈梨形及类圆形,彩色多普勒超声显示囊性结构内无血流信号显示。经产前彩色多普勒超声检查46例胎儿胆囊异常,其中32例胆囊未显示,10例胆囊增大,3例胆囊内可见强回声,1例为双胆囊。产后复查彩色多普勒超声显示产前32例未显示胆囊者28例产后复查彩色多普勒超声无异常,3例患有胆囊微小畸形,1例患有先天性胆道闭锁。产前彩色多普勒超声检查10例胆囊增大者产后复查超声显示7例无异常,2例患有微小畸形,1例患有严重畸形。产前彩色多普勒超声发现3例胆囊内强回声者产后复查证实为胆囊内结石,孕妇分娩出院后随诊6个月复查后消失。产前彩色多普勒超声发现1例双胆囊者产后复查超声证实为先天性胆总管囊肿。结论:彩色多普勒超声能在产前清晰地显示胎儿胆囊情况,能准确诊断胎儿胆囊先天性疾病,且在随访中能动态观察胆囊的变化,能为临床医生提供重要的参考价值。

Objective: To investigate the clinical study of color Doppler ultrasound in the diagnosis of fetal gallbladder abnormalities. Methods:4300 pregnant women who underwent fetal color Doppler ultrasonography in Dalian Women and Children Medical Center(Group) from June 2017 to June 2019 were selected, of which 46 cases of fetal gallbladder abnormalities were followed up, and the results of prenatal color Doppler ultrasonography and postpartum re examination were analyzed and compared, follow up newborns for more than 6 months and judge their prognosis. Results: The ultrasonographic image of normal fetal gallbladder is similar to that of adult gallbladder. It is shown that the cystic structure on the right side of the umbilical vein is located in the intrahepatic segment in the abdominal section, slightly lower than the level of the gastric vesicle, and is pear-shaped and quasi-circular in the transverse and longitudinal sections, respectively. Color Doppler ultrasound shows that there is no blood flow signal in the cystic structure. 46 cases of fetal gallbladder abnormalities were examined by prenatal color Doppler ultrasound, including 32 cases of gallbladder not shown, 10 cases of gallbladder enlargement, 3 cases of strong echo in gallbladder and 1 case of double gallbladder. Postpartum color Doppler ultrasound showed that 32 cases did not show gallbladder before delivery, 28 cases had no abnormality after postpartum color Doppler ultrasound, 3 cases had micro malformation of gallbladder and 1 case had congenital biliary atresia. Prenatal color Doppler ultrasonography in 10 cases of gallbladder enlargement, postpartum ultrasound showed that 7 cases had no abnormalities, 2 cases had minor malformations and 1 case had severe malformations. 3 cases of strong echo in the gallbladder were found by prenatal color Doppler ultrasound. The stones were confirmed by postpartum reexamination. The pregnant women were followed up for 6 months after delivery. 1 case of double gallbladder was found by prenatal color Doppler ultrasound. Postpartum ultrasound confirmed that it was a congenital choledochal cyst. Conclusion: Color Doppler ultrasound can clearly display the situation of fetal gallbladder before delivery, accurately diagnose the congenital diseases of fetal gallbladder, and dynamically observe the changes of gallbladder during follow-up. It can provide important reference value for clinicians.