摘要
目的 探讨双胎无心反向动脉灌注（twin reversed arterial perfusion TRAP）的产前超声声像图特征。方法 回顾性分析3例产前超声诊断为TRAP的超声图像与随访结果，总结声像图特点。结果 2例产后病检证实为TRAP，1例失访。TRAP的特点是，双胎或三胎中均有一个胎儿无头无心畸形，胸腹腔内没有正常内脏结构，无正常上肢结构，可见下肢及下肢运动。皮肤及皮下组织明显增厚，均为单脐动脉；彩色多普勒显示无心胎儿体内出现没有心脏的血液循环通路；频谱多普勒记录到进人胎儿体内脐血管为动脉频谱，出胎儿腹壁的脐血管为静脉频谱，形成了与正常胎儿灌注方向完全相反的灌注特点。结论 多胎妊娠中（包括双胎和三胎）若有单卵双胎，且其中之一伴有严重畸形、无心脏结构与搏动，彩色多普勒记录到进入无心胎儿体内的脐血管为动脉频谱，出胎儿的血管为静脉频谱，为TRAP的重要声像图特征。
Objective To investigate prenatal sonographic features of twin reversed arterial perfusion （TRAP）. Methods Retrospective analysis was conducted in 3 cases of prenatal diagnosed TRAP and the following-ups. Sonographic characteristics was summarized. Results TRAP was confirmed by autopsy in 2 cases, and 1 was lost. The gray ultrasonography examination revealed an acardiac, anencephalic twin without upper limbs and severe agenesis of the thoracoabdominal organs. Movements of the lower extremities were observed. Color Doppler ultrasonographic images of TRAP showed absence of cardiac pulsation and arterial blood flows towards the acardiac twin within the umbilical artery and venous blood flew in the opposite direction. Conclusions The ultrasonographic characteristics of TRAP is the umbilical arterial ware towards the abnormal fetus and the umbilical venous wave away from the abnormal fetus, which is severely deformed and acardiac activity when the fetus is one of the monozygotic twins in multifetation （cincluding twins and triplets）.
出处
《中华围产医学杂志》
CAS
2007年第4期248-251,289,共5页
Chinese Journal of Perinatal Medicine
关键词
妊娠
多胎
畸胎
超声检查
产前
超声检查
多普勒
彩色
Pregnancy, multiple
Monsters, Ultrasonography, prenatal
Ultrasonography,doppler, color
