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中华医学超声杂志(电子版) ›› 2021, Vol. 18 ›› Issue (01) : 62 -67. doi: 10.3877/cma.j.issn.1672-6448.2021.01.013

所属专题: 文献

妇产科超声影像学

产前超声在评价腭裂骨缺损中的应用
胡佳琪1,(), 张玉国1, 刘一1, 何娟1, 黄佳1, 石华1   
  1. 1. 430060 武汉大学人民医院妇产超声科
  • 收稿日期:2019-11-12 出版日期:2021-01-01
  • 通信作者: 胡佳琪

Application of prenatal ultrasonography in evaluating bone defect in palate cleft

Jiaqi Hu1,(), Yuguo Zhang1, Yi Liu1, Juan He1, Jia Huang1, Hua Shi1   

  1. 1. Department of Ultrasonography Center of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060, China
  • Received:2019-11-12 Published:2021-01-01
  • Corresponding author: Jiaqi Hu
引用本文:

胡佳琪, 张玉国, 刘一, 何娟, 黄佳, 石华. 产前超声在评价腭裂骨缺损中的应用[J]. 中华医学超声杂志(电子版), 2021, 18(01): 62-67.

Jiaqi Hu, Yuguo Zhang, Yi Liu, Juan He, Jia Huang, Hua Shi. Application of prenatal ultrasonography in evaluating bone defect in palate cleft[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(01): 62-67.

目的

总结不同类型、程度腭裂骨缺损的胎儿产前超声特征。

方法

回顾2018年2月至2019年10月在武汉大学人民医院诊断的唇腭裂、单纯腭裂和黏膜下腭裂胎儿上腭的二维和三维图像,对照出生后或引产后结果进行分析。

结果

产前超声诊断并随访到47例唇腭裂、3例单纯腭裂和2例黏膜下腭裂。牙槽突裂病例中,均可见牙槽突回声中断,97.9%与产后检查相符,完全性牙槽突裂中78.4%可见牙槽错位,89.2%可见鼻中隔。继发腭裂病例中,均可见腭骨水平板强回声带回声中断,88.2%可见鼻中隔,完全继发硬腭裂未见硬软腭的弧形带状回声,部分继发硬腭裂可见短棒状硬腭高回声而未见软腭,而黏膜下腭裂可见硬软腭的弧形带状回声。

结论

产前结合二维和三维超声,了解牙槽突和继发腭骨缺损的部位、程度和类别,可为产前咨询提供更多信息。

Objective

To summarize the prenatal ultrasonic features of different types and degrees of bone defect in cleft palate.

Methods

The two-dimensional and three-dimensional images of fetuses with cleft lip, cleft palate, or submucous cleft palate diagnosed at our hospital from February 2018 to October 2019 were retrospectively reviewed and compared with the results obtained after birth or termination of pregnancy.

Results

Prenatal ultrasonography and postnatal follow-up revealed 47 cases of cleft lip and palate,3 cases of isolated cleft palate, and 2 case of submucous cleft palate. The interruption of the alveolar ridge could be detected prenatally in all cleft alveolar cases, in which 97.9% were consistent with the postpartum examination. Approximately 78.4% of the complete cleft alveolar cases showed alveolar dislocation, and 89.2% had the nasal septum. The interruption of the horizontal plate of the band-shaped palate could be detected in all the cases of cleft secondary palate, and 88.2% had the nasal septum. In complete cleft hard palate cases, arc-shaped echoes of the hard and soft palate could not be seen, while short hyperechoic hard palate could be seen without the soft palate in partial cleft hard palate. However, arc-shaped echoes of the hard and soft palate could still be detected in submucosal cleft palate.

Conclusion

Two-dimensional combined with three-dimensional ultrasound can be used to assess the type and degree of bone defects in cleft alveolus and secondary palate to provide more information for prenatal consultation.

图1 一例完全性牙槽突裂不伴继发硬腭裂病例的腭骨水平板轴切面,箭头所示为连续的腭骨水平板强回声带
图2 一例完全性牙槽突裂不伴继发硬腭裂病例的上腭矢状切面,可见硬、软腭组成的弧形带状回声,★示牙槽后方上腭回声中断
图3 一例单侧完全性牙槽突裂不伴继发硬腭裂病例的上腭三维成像,对照左下角引产后口腔检查图片,★示牙槽回声中断并错位
图4 一例双侧完全性牙槽突裂不伴继发硬腭裂病例的上腭三维成像,对照左下角引产后口腔检查图片,★示牙槽回声中断并错位
图5 一例继发硬腭裂的病例的腭骨水平板轴切面,箭头所示为回声中断的硬腭
图6 一例完全性牙槽突裂伴完全继发硬腭裂病例的上腭矢状切面,未见硬、软腭组成的弧形带状回声,口腔顶部可见鼻中隔下缘
图7 一例Pierre-Robin序列征部分继发硬腭裂病例的上腭矢状切面,可见短棒状硬腭高回声,未见向后下延续的软腭回声,舌后移,舌尖抵硬腭后。
图8 一例黏膜下腭裂病例的上腭矢状切面可见硬腭和向后延续的软腭回声
图9 一例单侧完全性牙槽突裂伴完全继发硬腭裂病例的上腭三维成像图 ★示牙槽突和继发腭连续中断
图10 一例双侧完全性牙槽突裂伴完全继发硬腭裂病例的上腭三维成像图 箭头所示为鼻中隔
图11 一例PP病例的上腭三维成像,对照左下角出生后口腔检查图片。★示继发腭骨缺损处
图12 一例SP病例的上腭三维成像,对照左下角引产后口腔三维CT图片,箭头所示为继发腭骨缺损处
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