胎儿体表结构发育畸形的三维超声研究

Prenatal Study of Fetal Surface Structures Dysplasia with Three Dimension Ultrasound

目的 :探讨三维超声 (包括静态及实时三维超声 )联合应用在胎儿体表结构畸形成像中的临床应用价值。方法 :采用表面成像方法对 11例产前常规二维超声检查怀疑胎儿表面结构异常的病例进行三维超声成像检查 ,通过产后检查结果对照 ,比较二维、静态三维、实时三维图像提供的畸形部位、形态改变等信息的准确性、直观性以及图像采集的成功率。结果 :三维图像可直观显示胎儿体表结构异常特征、立体形态及各结构间位置关系 ,丰富了空间位置信息。实时三维图像不仅可以获得胎儿立体图像 ,而且还可以跟踪胎儿运动 ,提高了三维图像成功率。 11例胎儿体表结构发育异常中 ,颅骨畸形 3例 ,脊椎裂 2例 ,唇裂 1例 ,足内翻 1例 ,颈部淋巴囊肿 4例 ,其中 10例静态三维扫查成功 ,所有病例都能进行实时三维检查 ,并得出三维立体图像。同时静态三维出现了 1例假阳性。产前二维、静态三维、动态实时三维对病变准确判断分别是 8例 (72 .7% ) ,10例 (90 .9% ) ,11例 (10 0 % )。结论 :三维超声对胎儿体表结构畸形的诊断率更高 ,外貌特征更形象 ,是二维超声的重要补充。实时三维图像提供了更丰富的诊断信息 ,是静态三维图像的进一步补充 ,提高了胎儿畸形的产前确诊率。

Objective:To evaluate the clinical value of using the thr ee dimensiona l ultrasonography (3D US), which include still and real time three dimensional u ltrasonography,in denonstrating the fetal surfaee structures abnormality. Meth ods:Eleven pregnant women suspected of having fetal surfaee structures abnormal dysplasia with routine prentatal two dimensional ultrasound(2D US) were examin ed with 3D US. The accuracy of 2D,still 3D and real time 3D diagnosis for the ma formation with detail were compare to pathology outcome, and the rate to obtain images were compared. Results: 3D US could demonstrate the surface features and stereo shape of the fetal surface structures,as well as the spatial relationsh ip among them.3D US give a clear view of the abnormality and reliable information, Not only re al time 3D US gathered 3D images of fetals,But it also abserved the movement.Th e successful rate of gathering 3D images were increased. Eleven cases of the fet al surface structures dysplasias included absent skull(n =3),spinal segmentatian defects(n=2), cleftlip(1),clubfoot(1) cystic lymphaic n eed(4). All cases obtain ed still 3D US and real time 3D US scanned data and 3D images with surface mode. Meanwhile, a case of false positive was found with still 3D US. Prenatal 2D US only determined the site of abnormality in eight cases(72.7%), for still 3D US, they were 10 cases (90.9%), for real time 3D US, they were 11 cases(100%). All 3 D US described the abnormality in detail. Conclusion:The diagnostic rate of 3D U S is increased in fetal surface structures abnormality, which compare with 2D US . 3D images is more imaginal. 3D US can be a very important complement to 2D US. The real time 3D US images can provide more imformations for clinician. It ha s incomparable significance beyond still 3D US. It can paly a great role in pren atal diagnosis.