三维超声表面模式在胎儿唇腭裂诊断中的应用

在围生期医学中,胎儿畸形的产前诊断是提高出生人口素质的重要环节。唇腭裂是最常见的胎儿颜面部先天性畸形,我国的发病率为0.182%[1],唇腭裂畸形已上升为胎儿畸形的第四位。唇腭裂不仅造成患儿的容貌畸形,而且影响患儿吸吮、吞咽、语言及面部发育等功能。产前正确诊断唇腭裂并明确其类型对提高人口素质具有重要意义。     

断层超声显像技术诊断胎儿唇腭裂的价值

目的:探讨断层超声显像技术(TUI)诊断胎儿唇腭裂的价值.材料和方法:对经二维超声检查疑有胎儿唇腭裂的孕妇进行TUI检查,观察分析胎儿唇腭裂在冠状切面、横切面及矢状切面的声像图表现,超声诊断与产后或引产后结果对照.结果:检出胎儿唇腭裂7例,均获得较满意的胎儿唇腭部TUI图像,所显示的唇腭部畸形与胎儿实际畸形相符.结论:TUI技术可清晰地显示胎儿唇腭部,是二维超声有益的补充.     

应用三维超声对胎儿体表畸形诊断的价值

目的:探讨胎儿体表畸形三维超声成像的诊断价值.方法:利用具有实时三维容积成像功能的超声诊断仪对7241名孕龄18～41周的胎儿进行二维和三维超声对照检查,统计两种超声成像胎儿体表畸形的检出率,与引产结果进行比对,分析三维超声成像的优势.结果:发现胎儿体表畸形42例,二维超声诊断正确者32例,三维超声进一步检查诊断正确者共39例,7例体表畸形胎儿二维超声检查不能作出明确诊断,二维及三维超声检查漏诊1例右手六指畸形,1例单纯腭裂畸形,1例小耳畸形.二维及三维超声对畸形诊断正确率分别为76.2%(32/42),92.9%(39/42).结论:三维超声图像立体、直观,对胎儿体表畸形的诊断优于单纯使用二维超声,有较高的临床应用价值,是提高产前诊断水平的一个可靠的技术手段.     

产前三维超声与MRI筛查胎儿畸形准确率及对畸形部位检出率分析

目的探讨产前三维超声与MRI筛查胎儿畸形准确性及对畸形部位检出率的影响。方法选取2018年4月～2019年2月我院和广州医科大学第一附属医院,高度疑似胎儿畸形的55例孕妇作为观察对象,所有孕妇均行产前三维超声及MRI筛查诊断,以出生后随访及临床病理诊断结果为标准,分析不同产前诊断方法对胎儿畸形筛查诊断的准确率。结果病理诊断结果得出,55例高度疑似胎儿畸形孕妇中,38例确诊为胎儿畸形;三维超声筛查诊断,35例确诊为胎儿畸形,漏诊3例,诊断准确率92.11%; MRI诊断结果,37例确诊为胎儿畸形,漏诊1例,诊断准确率97.37%; MRI诊断胎儿畸形准确率略高于三维超声诊断,但两者数据比较差异无统计学意义(P 0.05);以病理诊断结果为标准,对比三维超声与MRI诊断结果,比较差异无统计学意义(P0.05);畸形部位诊断准确率比较,磁共振诊断明显高于三维超声诊断,差异有统计学意义(P 0.05)。结论产前三维超声与MRI技术筛查诊断胎儿畸形具有较高的准确率,但在诊断畸形部位方面磁共振优于超声,临床应用时可根据孕妇及胎儿特点合理选择,提高筛查准确率。     

三维超声表面成像对胎儿唇腭裂畸形的诊断

胎儿唇腭裂是胎儿颜面部常见的先天畸形,以往诊断主要依靠二维超声,常常难以获得完整的鼻唇部图像,容易漏诊。三维超声能直观地显示胎儿鼻唇部的结构,安全便捷,且易被孕妇接受。我院近期行产前三维超声检查2 681例,发现21例唇腭裂畸形,报道于后,供同道参考。1资料与方法1·1一般资料收集自2004年6月~2006年12月在我院行三维超声检查的孕妇2 681例;年龄23~41岁,平均28·72岁。孕周17~40周,超声发现唇腭裂21例,其中经引产17例,足月分娩4例,所有胎儿均追踪至分娩后证实。1·2仪器采用Voluson 730三维彩色超声诊断仪,凸阵三维容积探头,频率4·0…     

唐氏综合筛查联合彩色多普勒超声诊断高龄孕妇胎儿畸形的应用价值

目的探讨唐氏综合筛查联合三维、四维超声在诊断高龄孕妇胎儿畸形中的价值。方法选择我院行产前检查的2278例高龄孕妇为观察对象,所有孕妇均接受唐氏综合筛查,对疑似胎儿畸形的孕妇再联合三维超声、四维超声检查进行诊断,评估三种检查方式联合的诊断价值。结果引产及胎儿出生结果证实,2278例高龄孕妇中共检出63例畸形胎儿。联合检查的胎儿畸形的阳性率及诊断准确率均明显高于唐氏综合筛查、三维超声、四维超声的单项检查,差异具有统计学意义(P 0. 05)。结论唐氏综合筛查联合三维、四维超声在诊断高龄孕妇胎儿畸形中应用价值较高,可降低畸形胎儿出生率,值得临床运用。     

二维结合三维超声诊断胎儿严重手畸形7例

手缺失属于严重手畸形,出生后给患儿及其家属造成极大痛苦。本文回顾性分析7例手缺失胎儿的超声影像学资料,探讨二维结合三维超声检查诊断胎儿严重手畸形的应用价值。     

三维超声对胎儿体表畸形的诊断价值

目的:探讨三维超声成像在胎儿体表畸形诊断的临床价值。方法:利用三维超声仪对在我院进行产前检查的妊娠20~41周的3241例孕妇、共3277个胎儿进行二维及三维超声检查,统计并比较超声诊断与随访结果。结果:140例各种发育异常胎儿,其中体表畸形胎儿34例,二维超声诊断正确者21例,9例体表畸形胎儿二维超声检查不能作出明确诊断;三维超声进一步检查诊断正确者共30例;二维及三维超声检查误诊1例胎儿足内翻,生后证实正常,漏诊1例耳廓缺失、2例多指畸形,生后随访证实。三维超声对胎儿体表畸形检出的敏感性、特异性及准确性分别为90.91%、99.97%、99.88%;二维超声对胎儿体表畸形检出的敏感性、特异性及准确性分别为63.64%、99.97%、99.60%。结论:三维超声能直观显示胎儿体表结构,三维超声检查诊断胎儿体表畸形的敏感性、特异性及准确性高,是二维超声检查的重要补充,与二维超声联合应用,可提高胎儿体表畸形的检出率。     

应用三维超声成像评价胎儿畸形的初步临床应用研究

目的：评价三维超声成像技术在诊断胎儿畸形中的应用价值。方法：所有患者先常规作二维超声检查。之后再由同一操作者行三维超声检查。并将二维及三维超声检查结果相对照。结果：６６例孕妇６７例胎儿中,共检查出胎儿异常１７例,其中３例为胎儿宫内发育迟缓,１４例为胎儿畸形,余５０例未发现异常。在１４例胎儿畸形中,有８例（５７％）三维超声可提供更多的诊断信息;有６例（４３％）二维超声即能诊断,三维超声未能提供更丰富     

三维超声诊断胎儿肢体畸形的临床应用

目的探讨三维超声在产前诊断胎儿肢体畸形中的临床应用价值。方法对1526例孕妇进行三维超声检查,并与引产及生产结果对照。结果16例胎儿肢体畸形的孕妇产前三维超声准确诊断14例,诊断不全1例,漏诊1例。本组产前三维超声诊断的准确率为93．75％,漏诊率6．25％。结论三维超声可以明显提高胎儿肢体畸形产前诊断的准确性,其图像生动逼真,有利于临床医师及患者全面了解胎儿肢体的解剖结构及畸形状况,为临床处置方案的制定提供较为客观的依据。     

Complete sternal cleft

Complete sternal clefts are rare congenital anomalies, which may be associated with other abnormalities of midline fusion. We here present a case with a complete cleft as the only anomaly of midline fusion.     

Intrasphenoidal rathke cleft cyst

Symptomatic Rathke cleft cysts (RCC) are reported in the sellar and suprasellar regions, but no case of sphenoidal RCC has been reported. We report a case of sphenoidal RCC in a 41-year-old man. The lesion was revealed by headaches and diplopia. Symptoms disappeared transiently after a spontaneous rhinorrhea but relapsed 4 months later. MR imaging showed a cystic sphenoidal lesion, isointense on T1-weighted images (WI) with peripheral gadolinium enhancement and hyperintense on T2 WI. The patient underwent surgery through a transrhinoseptal approach. The wall of the sphenoid sinus was paper-thin. The cyst contained a motor-oil-like fluid and communicated widely with the nasal fossa. Its wall was partially extracted. Symptoms and signs ceased after surgery. MR imaging performed 1 year later showed the disappearance of the sphenoidal cyst. Embryological origin of RCCs is discussed. The hypothesis of a continuum between the different epithelial cystic lesions of the sellar and parasellar region is discussed. Imaging has an important impact on the diagnosis; nevertheless, the specific characterization remains difficult.     

Acquired coronal cleft vertebra

Five patients with acquired coronal clefts in lower lumbar vertebral bodies are presented. The appearances on plain radiographs, skeletal scintigraphy, discography, computed tomography and magnetic resonance imaging (MRI) are described. The aetiological factors are discussed with particular emphasis on the role of the intervertebral disc and the discovertebral junction in the pathomechanics of vertebral body injury. Magnetic resonance imaging was helpful in the radiological assessment and provided information from which an explanation of the clefts could be proposed.     

超声对胎儿唇腭裂畸形的诊断价值

目的:探讨B超及CDFI诊断胎儿唇腭裂畸形的价值。方法:采用B超及CDFI对孕20~41周的胎儿进行唇面部超声检查,口唇清晰显示者与引产或足月产后进行对照。结果:在胎儿面部清晰显示的10 521例中共发现胎儿唇腭裂畸形19例,超声产前检出16例,漏诊3例,检出率84.21%。结论:胎儿唇弓回声中断、牙槽骨“双弧形”和硬腭“弧形”强回声不连续分别是唇裂、牙槽骨裂和硬腭裂的直接征象;上唇结节回声失落,鼻小柱向健侧移位,患侧鼻翼内陷是唇腭裂的常见声像图表现,CDFI胎儿上、下唇动脉分布异常或中断为间接征象。     

Giant Rathke cleft cyst.

The preoperative diagnosis for an unusual skull base lesion was chordoma. The combination of imaging, pathologic, and surgical findings suggests the diagnosis of Rathke cyst.