切换至 "中华医学电子期刊资源库"

中华医学超声杂志(电子版) ›› 2017, Vol. 14 ›› Issue (08) : 613 -617. doi: 10.3877/cma.j.issn.1672-6448.2017.08.009

所属专题: 妇产科超声影像学 文献 妇产科超声

妇产科超声影像学

胎儿宫内肠套叠的超声特征分析
刘爽1, 马玉庆1, 吴青青1,()   
  1. 1. 100026 首都医科大学附属北京妇产医院超声科
  • 收稿日期:2017-03-06 出版日期:2017-08-01
  • 通信作者: 吴青青
  • 基金资助:
    北京市医院管理局"登峰"计划专项经费资助(DFL20151302); 首都卫生发展科研专项(首发2014-2-2113); 国家卫生和计划生育委员会-国家科技支撑计划:重大出生缺陷防治技术开发及应用研究(2014BAI06B05)

Prenatal diagnosis of intrauterine intussusception by ultrasonography

Shuang Liu1, Yuqing Ma1, Qingqing Wu1,()   

  1. 1. Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
  • Received:2017-03-06 Published:2017-08-01
  • Corresponding author: Qingqing Wu
  • About author:
    Corresponding author: Wu Qingqing, Email:
引用本文:

刘爽, 马玉庆, 吴青青. 胎儿宫内肠套叠的超声特征分析[J/OL]. 中华医学超声杂志(电子版), 2017, 14(08): 613-617.

Shuang Liu, Yuqing Ma, Qingqing Wu. Prenatal diagnosis of intrauterine intussusception by ultrasonography[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(08): 613-617.

目的

探讨胎儿宫内肠套叠超声声像图特征。

方法

对2014年1月至2016年12月在首都医科大学附属北京妇产医院产前超声检出的5例宫内肠套叠胎儿的超声表现进行分析。

结果

5例胎儿肠套叠直接超声征象为"同心圆征"、"套筒征"、"面包圈征"和"新月征";间接超声征象为肠梗阻及胎粪性腹膜炎等。产科处理及随访结果:3例剖宫产紧急终止妊娠,出生儿转小儿外科手术,手术检查均证实为宫内肠套叠,患儿术后均恢复良好。另2例胎儿产前继发胎粪性腹膜炎,自然分娩后转小儿外科行剖腹探查术,均证实均为肠套叠,两患儿并发肠闭锁,术后死亡。

结论

胎儿宫内肠套叠与肠梗阻、胎粪性腹膜炎及肠道闭锁密切相关,产前超声检查正确识别胎儿肠套叠特征性超声表现及其并发症,对指导产科处理和胎儿出生后手术治疗有重要作用。

Objective

To discuss the prenatal ultrasound manifestations of intrauterine intussusception.

Methods

An analysis of prenatal ultrasound findings and postnatal features was performed on five cases of fetuses with intrauterine intussusception that were identified by ultrasonography at Beijing Obstetrics and Gynecology Hospital, in the period of January 2014 to December 2016.

Results

The 5 fetuses with intrauterine intussusception were diagnosed based on the typical ″target sign″, ″telescope sign″, ″doughnut sign″ and ″crescent-in-doughnut sign ″in ultrasonography. Indirect and non-specificultrasonographic signs included dilatation of intestine and ascites. Three cases of emergency caesarian section were performed, and infants underwent surgeries. The intraoperative findings confirmed the prenatal diagnosis, and postoperativelythe infantsrecovered uneventfully. In another 2 cases, whichwere suspected the presence of meconium peritonitis, fetus prematurely bornvia a spontaneous vaginal delivery, and the intraoperative findings confirmed the prenatal diagnosis. However, intestinal atresia occurred, and the neonates died postoperatively.

Conclusions

Fetuses with intrauterine intussusceptionshad characteristic ″target sign″, ″telescope sign″, ″doughnut sign″ and ″crescent-in-doughnut sign″ in ultrasonography. Ultrasonography may be used as the first choice for prenatal diagnosis of this disease. Prenatal diagnosis of intrauterine intussusception can provide guidance for clinical obstetrical management and postnatal treatment.

图1~6 胎儿宫内肠套叠产前超声声像图。图1胎儿套叠肠管短轴切面呈"同心圆征"(箭头所示);套叠上方肠管高张力扩张,套叠下方肠管挛缩回声增强;图2 胎儿套叠肠管长轴切面呈"套筒征"(箭头所示);套叠上方肠管高张力扩张,套叠下方肠管回声增强;可见少量腹腔积液;图3胎儿套叠肠管短轴切面呈"面包圈征"(箭头所示),上方肠管高张力扩张呈现不典型的"漩涡征",提示伴发宫内肠扭转;图4胎儿套叠肠管部位管口水平扫查可见由肠系膜折入套叠肠管间所形成的"新月征"(箭头所示);图5胎儿肠套叠导致高张力扩张肠管穿孔后产生大量腹腔积液;图6胎儿宫内肠套叠腹腔积液吸收后伴发胎粪性腹膜炎,下腹部可见高回声钙化灶
表1 5例宫内肠套叠胎儿产前超表现及产科处理结局(例数)
1
刘文英,唐耘熳,胡廷泽, 等. 胎儿、新生儿和小婴儿肠套叠 [J]. 中华小儿外科杂志, 2002, 23(1): 65-66.
2
中国医师协会超声医师分会. 产前超声检查指南(2012) [J/CD]. 中华医学超声杂志(电子版), 2012, 9(7): 574-580.
3
Lin CH, Wu SF, Lin WC, et al. Meckel′s diverticulum induced intrauterine intussusception associated with ileal atresia complicated by meconium peritonitis [J]. J Formos Med Assoc, 2007, 106(6): 495-498.
4
del-Pozo G, Albillos JC, Tejedor D. Intussusception: US findings with pathologic correlation--the crescent-in-doughnut sign [J]. Radiology, 1996, 199(3): 688-692.
5
Hokama A, Kinjo T, Kishimoto K, et al. Crescent-in-doughnut sign and telescope sign of intussusception in Peutz-Jeghers syndrome [J]. BMJ Case Rep, 2014, 2014(apr17 1).
6
Yang JI, Kim HS, Chang KH, et al. Intrauterine intussusception presenting as fetal ascites at prenatal ultrasonography [J]. Am J Perinatol, 2004, 21(4): 241-246.
7
Shimotake T, Go S, Tsuda T, et al. Ultrasonographic detection of intrauterine intussusception resulting in ileal atresia complicated by meconium peritonitis [J]. Pediatr Surg Int, 2000, 16(1-2): 43-44.
8
Sarin YK. Intrauterine intussusception causing ileal atresia [J]. APSP J Case Rep, 2010, 1(2): 18.
9
Ohuoba E, Fruhman G, Olutoye O, et al. Perinatal survival of a fetus with intestinal volvulus and intussusception: a case report andreview of the literature [J]. AJP Rep, 2013, 3(2): 107-112.
10
Komuro H, Hori T, Amagai T, et al. The etiologic role of intrauterine volvulus and intussusception in jejunoileal atresia [J]. J Pediatr Surg, 2004, 39(12): 1812-1814.
11
刘爽,吴青青. 胎儿肠旋转不良伴中肠扭转超声诊断研究 [J/CD]. 中华医学超声杂志(电子版), 2016, 13(11): 840-844.
12
Avansino JR, Bjerke S, Hendrickson M, et al. Clinical features and treatment outcome of intussusception in premature neonates [J]. J Pediatr Surg, 2003, 38(12): 1818-1821.
[1] 戴飞, 赵博文, 潘美, 彭晓慧, 陈冉, 田园诗, 狄敏. 胎儿心脏超声定量多参数对主动脉缩窄胎儿心脏结构及功能的诊断价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 950-958.
[2] 杜祖升, 赵博文, 张帧, 潘美, 彭晓慧, 陈冉, 毛彦恺. 应用二维斑点追踪成像技术评估孕周及心尖方向对中晚孕期正常胎儿左心房应变的影响[J/OL]. 中华医学超声杂志(电子版), 2024, 21(09): 843-851.
[3] 杨忠, 时敬业, 邓学东, 姜纬, 殷林亮, 潘琦, 梁泓, 马建芳, 王珍奇, 张俊, 董姗姗. 产前超声在胎儿22q11.2 微缺失综合征中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(09): 852-858.
[4] 张商迪, 赵博文, 潘美, 彭晓慧, 陈冉, 毛彦恺, 陈阳, 袁华, 陈燕. 中晚孕期胎儿心房内径定量评估心房比例失调胎儿心脏畸形的价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 785-793.
[5] 王秋莲, 张莹, 李春敏, 徐树明, 张玉奇. 胎儿主动脉弓部梗阻伴发复杂心内畸形的产前超声诊断及漏误诊分析[J/OL]. 中华医学超声杂志(电子版), 2024, 21(07): 718-725.
[6] 顾莉莉, 姜凡. 安徽省超声产前筛查切面图像质量现状调查情况及分析[J/OL]. 中华医学超声杂志(电子版), 2024, 21(07): 671-674.
[7] 曾晴, 文华轩, 袁鹰, 廖伊梅, 秦越, 罗丹丹, 梁美玲, 李胜利. 经腹二维超声评价胎儿大脑外侧裂的新参数——外侧裂平台角度[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 454-459.
[8] 王水清, 赵博文, 潘美, 彭晓慧, 陈冉, 马明明, 狄敏. 16~40周正常胎儿左心房后间隙指数及其Z评分的定量研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 460-469.
[9] 项文静, 徐燕, 茹彤, 郑明明, 顾燕, 戴晨燕, 朱湘玉, 严陈晨. 神经学超声检查在产前诊断胼胝体异常中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 470-476.
[10] 罗刚, 泮思林, 孙玲玉, 李志新, 陈涛涛, 乔思波, 庞善臣. 一种新型语义网络分析模型对室间隔完整型肺动脉闭锁和危重肺动脉瓣狭窄胎儿右心发育不良程度的评价作用[J/OL]. 中华医学超声杂志(电子版), 2024, 21(04): 377-383.
[11] 张帧, 赵博文, 潘美, 彭晓慧, 陈冉, 田园诗, 陈阳. 二维斑点追踪技术评价正常中晚孕期胎儿右心房功能的初步研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(04): 384-390.
[12] 张盼盼, 赵博文, 潘美, 彭晓慧, 陈冉, 田园诗, 林仙方, 惠姗姗, 沈婷婷. 胎儿左心房后间隙指数在胎儿肺动脉瓣缺如综合征中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(04): 391-398.
[13] 王濛, 王華麟, 王鉴, 孙锟. 先天性心脏病宫内诊疗现状与展望[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 481-485.
[14] 徐婷婷, 詹泳池, 王晓东, 刘兴会. 电子胎心监测结果出现正弦波形的胎母输血综合征围生期结局分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 382-389.
[15] 吴少敏, 张世豪, 刘炳光, 李婵, 尹嘉敏, 郑昌业, 黄素然. 胎儿巨大蛛网膜囊肿并文献复习[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 390-397.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?