摘要
目的探讨鼻唇部彩色多普勒信号在诊断腭裂中的应用价值。方法选取在我院经产前超声筛查,并行正中矢状切面或旁矢状切面鼻唇部检测,经磁共振和产后随访证实为唇裂或唇腭裂的胎儿20例进行回顾性分析。胎儿在呼吸样运动或吞咽动作时鼻唇部测及相通彩色信号提示合并腭裂,鼻唇部未测及相通彩色信号提示未合并腭裂。与产后结果进行对照,评价鼻唇部测及相通彩色多普勒信号提示腭裂诊断的准确性。结果20例胎儿(引产或出生)中证实15例为唇裂合并腭裂,5例唇裂(其中2例唇裂合并上牙槽突裂)。二维超声共诊断5例单纯唇裂,15例唇腭裂,其中3例唇腭裂误诊为单纯唇裂,3例唇裂误诊为唇腭裂(其中2例唇裂合并上牙槽突裂);二维超声联合应用正中矢状切面鼻唇部处彩色信号诊断腭裂与出生后诊断情况一致,单纯唇裂及唇裂合并上牙槽突裂胎儿在呼吸样运动或吞咽动作时鼻唇部处未测及相通的彩色信号,唇腭裂胎儿鼻唇部处可测及相通的彩色信号。磁共振共检查出3例单纯唇裂,17例唇腭裂,其中2例磁共振诊断唇腭裂(实际为唇裂合并上牙槽突裂),鼻唇部处在呼吸样运动或吞咽动作时未测及相通彩色信号。结论应用彩色多普勒超声在胎儿呼吸样运动或吞咽动作时口腔与鼻唇部之间测及相通彩色信号可协助诊断腭裂,口腔与鼻唇部之间未检测出相通的彩色信号可初步排除腭裂。
Objective To evaluate the clinical value of color Doppler signal at the nasal lip in the diagnosis of fetal cleft palate. Methods Twenty fetuses diagnosed with fetal cleft lip and cleft palate by targeted ultrasonography and magnetic resonance imaging were enrolled in this study. Color Doppler was used during each ultrasound scan. All prenatal diagnoses were confirmed either by postnatal follow-up or autopsy. The location and degree of cleft lip and palate was also recorded. During inspiration or swallowing color signal acrossed the defects at the fetal palate was indicated cleft palate, and no color signal acrossed the defects at the fetal palate was indicated without cleft palate. Two dimensional ultrasound combined with color Doppler was used to diagnose cleft lip and palate in midsagittal plane or paratsagittal plane, then compared with the results of post-natal evaluation or abortion, and the value of color signal at the nasal lip in the diagnosis of fetal cleft palate was analyzed. Results Twenty cases of postpartum fetus (including post-natal evaluation or abortion ) confirmed 15 cases of cleft lip and palate, 5 cases of cleft lip (2 cases with upper alveolar cleft). For prenatal diagnosis, 5 cases of cleft lip and 15 cases of cleft lip and palate were diagnosed by two-dimensional ultrasound, of which 3 cases of cleft lip and palate were misdiagnosed as cleft lip, whereas 3 cases of cleft lip were misdiagnosed as cleft lip and palate with 2 cases combined with upper alveolar cleft. Two-dimensional ultrasound in the diagnosis of cleft lip and palate is consistent with postnatal results by additional evaluation of the color signal in nasolabial area in median sagittal section. In the cleft lip and cleft lip with the alveolar cleft fetuses, the color signal in nasolabial area was undetectable during fetal respiratory-like movement or swallowing by ultrasound.However, it was detectable in cleft lip and palate fetuses. A total of 3 cases of simple cleft lip and 17 cases of cleft lip and palate were detected by
作者
项小苗
潘姣娥
姚维妙
王军梅
Xiang Xiaomiao;Pan Jiaoe;Yao Weimiao;Wang Junmei(Department of Ultrasonography,Women′s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2019年第9期812-816,共5页
Chinese Journal of Ultrasonography
基金
浙江省教育厅科研项目(Y201636060).
关键词
超声检查
产前
腭裂
彩色多普勒信号
Ultrasonography, prenatal
Cleft palate
Color Doppler signal
