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中华医学超声杂志(电子版) ›› 2021, Vol. 18 ›› Issue (03) : 285 -289. doi: 10.3877/cma.j.issn.1672-6448.2021.03.008

所属专题: 妇产科超声影像学 产前超声 文献 妇产科超声

妇产科超声影像学

胎儿先天性白内障产前超声诊断及研究分析
郭家菊1, 秦越2, 李胜利2,()   
  1. 1. 518000 深圳仁爱医院超声科
    2. 518028 南方医科大学附属深圳妇幼保健院超声科
  • 收稿日期:2019-11-20 出版日期:2021-03-01
  • 通信作者: 李胜利
  • 基金资助:
    国家自然科学基金(81771598)

Prenatal ultrasound diagnosis and literature analysis of fetal congenital cataract

Jiaju Guo1, Yue Qin2, Shengli Li2,()   

  1. 1. Department of Ultrasound, Shenzhen Renai Hospital, Shenzhen 518000, China
    2. Department of Ultrasound, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen 518028, China
  • Received:2019-11-20 Published:2021-03-01
  • Corresponding author: Shengli Li
引用本文:

郭家菊, 秦越, 李胜利. 胎儿先天性白内障产前超声诊断及研究分析[J/OL]. 中华医学超声杂志(电子版), 2021, 18(03): 285-289.

Jiaju Guo, Yue Qin, Shengli Li. Prenatal ultrasound diagnosis and literature analysis of fetal congenital cataract[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(03): 285-289.

目的

探讨先天性白内障超声影像学分类特征,并对先天性白内障胎儿的临床结局进行研究。

方法

对2017年1月至12月在深圳仁爱医院产前筛查发现先天性白内障4例胎儿的超声影像分类特征及临床结局进行研究分析。

结果

产前超声提示:4例胎儿中1例晶状体呈完全性高回声,为1型先天性白内障;1例晶状体内呈点状高回声,为2型先天性白内障;2例晶状体内呈环状高回声,为3型先天性白内障。3例为孤立性白内障,孕母致畸病原体血清抗体检测结果呈阴性;1例合并小脑出血和胎儿贫血,引产后脐带血检测显示风疹病毒抗体(IgM)阳性。临床结局:2例孕母选择终止妊娠,1例失访,1例因宫内缺氧导致新生儿出生后死亡。

结论

先天性白内障是晶状体发育异常性疾病,产前超声表现为晶状体呈点状、环状高回声或完全性高回声,结合详细的解剖学扫查和病因学检查,可为先天性白内障胎儿产前咨询及出生后早期转诊和干预治疗提供更多信息。

Objective

To investigate the classification of congenital cataract, and to analyze the clinical outcome of congenital cataract.

Methods

Sonographic features and clinical outcomes of four cases of congenital cataract diagnosed by prenatal ultrasound at Shenzhen Renai Hospital between January and December 2017 were analyzed.

Results

Prenatal ultrasound indicated that one of the four cases had dense echogenic structure, which was type 1. One case of type 2 presented hyperechogenic spot in the lens. The "double ring" sign was found in 2 cases, which was type 3. Three cases were isolated cataract, and of which maternal TORCH screens were negative. One case was associated with cerebellar hemorrhage and fetal anemia, and umbilical cord blood test of rubella virus (IgM) was positive after induced labor. Clinical outcomes: the pregnancy was terminated in 2 cases, 1 case refused follow-up, and 1 case died after birth due to intrauterine hypoxia.

Conclusion

Congenital cataract is an abnormal disease of lens development. Prenatal ultrasound presents dense echogenic structure, hyperechogenic spot or "double ring" sign in the lens. Combined with detailed anatomical and etiological examination, it can provide more information for prenatal consultation and early referral and intervention treatment of congenital cataract after birth.

图1 孕24+4周胎儿(例1),产前超声晶状体冠状切面显示晶状体内呈点状高回声(箭头所示),产前超声诊断:先天性白内障(2型)
图2 孕22+2周胎儿(例2),产前超声双眼横切面显示双侧晶状体完全呈高回声(箭头所示),超声诊断:先天性白内障(1型)
图3 孕26+2周外院转诊胎儿(例3),产前超声眼部冠状切面显示晶状体呈"双环征"(箭头所示),超声诊断:先天性白内障(3型);该胎儿合并小脑出血及贫血
图4 孕27+2周胎儿(例4),产前超声检查双眼横切面显示晶状体呈"双环征"(箭头所示),超声诊断:先天性白内障(3型)
表1 4例白内障胎儿产前超声特征、潜在病因及围产期结局
表2 产前超声诊断孤立性先天性白内障的文献分析
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