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目的探讨三维超声检查在胎儿先天性椎体畸形中的分型诊断及对其预后评估的价值,为产前诊断胎儿椎体发育异常的分型建立诊断标准。方法产前三维超声诊断胎儿椎体畸形(均除外染色体异常)的胎儿,总结其声图像特征,与经典椎体畸形分型进行对比,与胎儿磁共振(MRI)、新生儿或引产后X线或尸检结果对比分析。结果 (1)椎体形成障碍型,即半椎体25例:完全分节型半椎体8例;部分分节型半椎体2例;未分节型半椎体2例;对称的双侧半椎体(蝴蝶椎)4例;不对称的同侧两个半椎体2例;多发半椎体7例。(2)椎体分节不良型,即融合椎8例:四周融合型,即阻滞椎6例;单侧融合型2例。(3)混合型:单侧部分融合并对侧半椎体;单侧部分融合并同侧半椎体。结论三维超声对胎儿先天性椎体发育异常进行分型是可行的,能为胎儿先天性椎体畸形预后评估提供有价值的信息。
Objective To investigate the diagnostic value of three-dimensional ultrasonography in the diagnosis of fetal congenital vertebral deformity and its prognostic value in order to establish the diagnostic criteria for the classification of prenatal diagnosis of fetal vertebral dysplasia. Methods Prenatal three-dimensional ultrasound diagnosis of fetus with fetal vertebral deformity (all except chromosomal abnormalities) fetus, summarizes the characteristics of acoustic images, compared with the classic vertebral body malformations, and fetus MRI, neonatal or postpartum X-ray Or autopsy results of comparative analysis. Results (1) Obstructive vertebral body formation, that is, 25 cases of hemivertebra: 8 cases of complete segmental hemivertebra; 2 cases of partial segmental hemivertebra; 2 cases of undivided hemivertebra; 4 cases of lateral hemivertebra (butterfly vertebra); 2 cases of asymmetric two half hemispheres; 7 cases of multiple hemivertebra. (2) vertebral poor segmental, that fusion of 8 cases: fusion around the type, that is, block the vertebra 6 cases; unilateral fusion in 2 cases. (3) mixed type: unilateral partial fusion and contralateral hemivertebra; unilateral partial fusion and ipsilateral hemivertebra. Conclusion It is feasible to classify the fetal congenital vertebral dysplasia by 3D echocardiography, which can provide valuable information for the prognosis evaluation of fetal congenital vertebral deformity.