米非司酮（Ru486）致不全流产16例分析

米非司酮（Ｒｕ４８６）致不全流产１６例分析３１２０００浙江绍兴市妇幼保健院徐关德，金社红我院自１９９３年１月起开始对停经４９天以内要求流产者实行药物流产，疗效较满意。但亦有少部分因药物流产不全致阴道多量出血的情况。此种现象不容忽视．现就本院自１９９３...     

超声诊断胎儿单心室畸形的临床价值

目的探讨超声诊断胎儿单心室畸形的临床价值。方法对所有受检胎儿在常规进行胎儿胎盘羊水等检查后,进行四腔心切面及左右流出道切面进行扫查,并对其发现的11例胎儿单心室的超声特点进行分析总结。结果 11例胎儿单心室畸形均经胎儿超声心动图复查或尸检证实,其中伴肺动脉狭窄8例。结论超声诊断胎儿单心室畸形具有较好的临床应用价值,但在检测中需密切注意胎儿四腔心的标准切面及房室间隔的完整性,以及左右心室流出道"剪刀样"交叉清晰显示,避免漏误诊。     

时间-空间相关成像技术对正常胎儿心脏大动脉空间角度的定量研究

目的 应用时间-空间相关成像(spatiotemporal image correlation,STIC)技术建立不同孕周胎儿心脏大动脉空间角度的正常参考值范围.方法 运用STIC采集352例孕20～38周正常胎儿的心脏三维数据,通过正交三平面模式测量标准四腔观与左室长轴观之间、左室长轴观与主肺动脉干观之间以及动脉导管弓观与主动脉弓观之间的角度.应用相关回归分析评价上述角度与孕周的相关性.结果 正常胎儿标准四腔观与左室长轴观的角度与孕周不相关(r=0.04,P=0.51),95%正常参考值范围为34.5°～56.7°.左室长轴观与主肺动脉干观之间以及动脉导管弓长轴观与主动脉弓长轴观之间的角度与孕周相关(r分别为-0.53、0.57,P＜0.001),回归方程分别为:Y=154-4.24X+0.05X2,Y=-20.8+2.65X-0.37X2.结论 STIC能定量测量20～38周胎儿心脏大动脉之间的角度并建立正常参考值范围,为产前筛查大动脉空间关系异常的先天性心脏病提供有价值的参考标准.

Abstract：

Objective To establish the reference ranges of the spatial angles among cardiac chambers and great vessels in second and third trimester fetuses measured by spatiotemporal image correlation (STIC).Methods Volume images of 352 normal fetuses from 20 to 38 weeks of gestation were recruited in the study.An off-line analysis of acquired volume datasets was carried out with multiplanar mode.Parameters measured included angles between:(1) the 4-chamber view and the left ventricular long axis view; (2) the left ventricular long axis view and main pulmonary artery; and (3) the ductal arch and aortic arch.The relationships between above-mentioned angles and gestational age were assessed by correlation and regression analysis.Results The angle between the 4-chamber view and the left ventricular long axis view (range:55.7° - 35.7°,mean:45.7° ± 5.12°) was uncorrelated with gestational age (r = 0.03,P = 0.51).In contrast,the angle between the left ventricular long axis view and main pulmonary artery,and the angle between the ductal arch and aortic arch were correlated with gestational age (P ＜ 0.001),and the correlation coefficient was - 0.53 and 0.57 respectively.The best-fit exponential curve regression equations of the angle between the left ventricular long axis view and main pulmonary artery was:Y = 154- 4.24X +0.05X2 ,and the angle between the ductal arch and aortic arch was:Y = - 20.8 + 2.65X - 0.37X2.Conclusions The angles among cardiac chambers and great arteries of fetuses from 20 to 38 weeks of gestation can be quantitatively measured by STIC.The reference ranges provide a reliable quantitative standard to estimate the spatial relationships of the cardiac large arteries of fetuses,which may be clinically useful in prenatal screening congenital heart disease.     

三维超声诊断胎儿先天性膈疝的临床价值

目的探讨产前超声诊断胎儿先天性膈疝的临床价值。方法选择2004年1月-2010年2月在我院进行产前三维超声的孕妇13 200例。结果胎儿先天性膈疝8例,伴发胎儿心脏畸形、脑积水、肾脏畸形等复合畸形3例,其中羊水过多4例。所有病例均接受羊水或脐血穿刺进行染色体检查,其中2例染色体异常,均为18-三体综合征。结论产前三维超声可准确定位并诊断胎儿先天性膈疝。     

三维超声诊断胎儿全前脑畸形的临床价值

目的探讨应用三维超声诊断胎儿全前脑畸形的临床价值。方法回顾分析总结了8例产前超声诊断中发现的全前脑畸形及伴发的畸形,以及与染色体核型异常的相关性。结果 8例全前脑畸形均有典型的特征,其中无叶全前脑5例,半叶全前脑3例,合并胎儿多发畸形3例(心脏畸形分别伴2例喙鼻,1例唇腭裂),染色体核型异常6例。结论应用产前三维超声检测胎儿可准确有效检出胎儿全前脑畸形。     

胎儿鼻骨超声检测的临床意义

安全剂量的超声检查对胎儿无损伤,重复性好,诊断准确,安全性高,是诊断与筛查胎儿畸形的首要诊断手段.随着遗传超声研究的不断深入,超声作为筛查胎儿染色体畸形,尤其是唐氏综合征已越来越受到重视.本研究通过超声检测胎儿不同孕周鼻骨长度,探讨胎儿鼻骨发育不良与染色体异常的关系,旨在评价超声检测胎儿鼻骨异常对筛查染色体畸形的临床意义.     

超声心动图对胎儿三尖瓣下移畸形的诊断价值

目的探讨超声心动图对胎儿三尖瓣下移畸形的诊断价值。方法回顾性分析5例经胎儿超声心动图检查诊断为三尖瓣下移畸形的声像图与随访结果,总结其二维及彩色多普勒血流声像图特点。结果 5例胎儿经尸解均证实为三尖瓣下移畸形。胎儿三尖瓣下移畸形的主要声像图特点表现为四腔心不对称,右心房增大,三尖瓣叶附着点下移,三尖瓣重度反流,反流起源点降低,反流面积大、反流速度低。结论超声心动图诊断胎儿三尖瓣下移畸形方法简单、可靠,对胎儿三尖瓣下移畸形的诊断具有重要的临床价值。