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中华医学超声杂志（电子版） ›› 2024, Vol. 21 ›› Issue (08) : 757 -761. doi: 10.3877/cma.j.issn.1672-6448.2024.08.002

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胎儿生物学参数超声参考值专家共识——双顶径、头围、腹围和股骨长
中华预防医学会出生缺陷预防与控制专业委员会产前超声诊断学组, 中华医学会超声医学分会妇产学组   
  1. 1. 100026　北京，首都医科大学附属北京妇产医院超声科
    2. 610041　成都，四川大学华西第二医院全国妇幼卫生监测办公室/中国出生缺陷监测中心　出生缺陷与相关妇儿疾病教育部重点实验室
  • 收稿日期:2024-06-30 出版日期:2024-08-01
  • 基金资助:
    国家重点研发计划(2022YFC2704700，2022YFC2704701，2022YFF0606305)

Expert consensus on ultrasound reference values of fetal biological parameters: biparietal diameter, head circumference, abdominal circumference, and femur length

Prenatal Ultrasound Diagnosis Group of Committee for Birth Defect Prevention and Control of Chinese Association of Preventive Medicine, Gynecology Group of Chinese Society of Ultrasound Medicine of Chinese Medical Association   

  • Received:2024-06-30 Published:2024-08-01
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中华预防医学会出生缺陷预防与控制专业委员会产前超声诊断学组, 中华医学会超声医学分会妇产学组. 胎儿生物学参数超声参考值专家共识——双顶径、头围、腹围和股骨长[J]. 中华医学超声杂志（电子版）, 2024, 21(08): 757-761.

Prenatal Ultrasound Diagnosis Group of Committee for Birth Defect Prevention and Control of Chinese Association of Preventive Medicine, Gynecology Group of Chinese Society of Ultrasound Medicine of Chinese Medical Association. Expert consensus on ultrasound reference values of fetal biological parameters: biparietal diameter, head circumference, abdominal circumference, and femur length[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 757-761.

双顶径（biparietal diameter，BPD）、头围（head circumference，HC）、腹围（abdominal circumference，AC）和股骨长（femur length，FL）等主要胎儿生物学参数的测量是胎儿生长评估的重要组成部分。通过超声检查获得胎儿生物学参数测量值，与胎儿生物学参数参考值比对，可以及时发现可能的胎儿生长异常[1,2]。

图1 主要胎儿生物学参数超声测量切面、测量方法及模式图。图a为经丘脑横切面测量双顶径（外-内）、头围，图d为对应的模式图；图b为腹围横切面测量腹围，图e为对应的模式图；图c为股骨长轴切面测量股骨长，图f为对应的模式图注：FL为股骨长；T为丘脑；TV为第三脑室；CP为大脑脚；CSP为透明隔腔；CC为胼胝体；AH为侧脑室前角；CN为尾状核；LS为大脑外侧裂；LIVER为肝脏；IVC为下腔静脉；AO为腹主动脉；ST为胃泡；SP为脊柱；UV为脐静脉
表1 主要胎儿生物学参数标准化测量方法
参数 测量切面 切面要求及观察内容 游标放置位置
BPD 经丘脑横切面 切面要求：显示颅骨强回声环、大脑镰、透明隔腔、两侧丘脑及丘脑后方的大脑脚
观察内容：颅骨强回声环呈椭圆形，大脑镰居中，第三脑室位于丘脑之间		 游标置于近端颅骨骨板外缘至远端颅骨骨板内缘（即"外-内"）
HC 经丘脑横切面 切面要求及观察内容同BPD 沿胎儿颅骨外缘包络测量头围径线，不包括头皮及软组织
AC 腹围横切面 切面要求：显示胃泡及脐静脉腹内段
观察内容：胃泡位于腹腔左侧；腹主动脉位于脊柱左前方；下腔静脉位于脊柱右前方		 沿腹壁皮肤外缘测量
FL 股骨长轴切面 切面要求：显示股骨长轴（双侧）
观察内容：观察股骨形态、长短		 测量一侧骨化的股骨干骺端中点之间的距离
表2 主要胎儿生物学参数超声测量切面及质控标准
超声测量切面 测量指标 质控要点
经丘脑横切面 BPD、HC 1.丘脑可见
2.透明隔腔可见（18~37周[14,15]）
3.小脑不可见
4.大脑脚、大脑外侧裂可见
5.对称平面：显示颅骨强回声环，颅骨强回声环呈椭圆形，大脑镰居中
6.感兴趣区图像放大至超声图像区域50%以上
7.测量游标放置正确
腹围横切面 AC 1.胃泡可见
2.脐静脉连接门静脉窦水平
3.脊柱横切面
4.肾脏不可见、肺不可见
5.单侧仅可显示一条肋骨
6.感兴趣区图像放大至超声图像区域50%以上
7.测量游标放置正确
股骨长轴切面 FL 1.股骨上下两侧的干骺端清晰显示
2.声束尽可能垂直于股骨长轴（长轴与水平线的夹角<15°）
3.感兴趣区图像放大至超声图像区域50%以上
4.测量游标放置正确
表3 NICHD亚裔种族单胎胎儿生物学参数超声参考值（mm）
孕龄（周） 双顶径（BPD） 头围（HC）
3rd 5th 10th 50th 90th 95th 97th 3rd 5th 10th 50th 90th 95th 97th
10 10.0 10.2 10.5 11.8 13.3 13.8 14.1 39.9 40.6 41.7 45.9 50.4 51.8 52.7
11 12.9 13.2 13.6 15.2 17.0 17.6 17.9 50.6 51.5 52.8 57.8 63.3 64.9 66.0
12 16.1 16.4 16.9 18.9 21.0 21.7 22.1 62.2 63.2 64.8 70.6 77.0 78.9 80.2
13 19.4 19.8 20.4 22.6 25.1 25.9 26.4 74.3 75.4 77.2 83.9 91.1 93.3 94.7
14 22.8 23.2 23.9 26.4 29.2 30.1 30.6 86.6 87.9 89.9 97.3 105.3 107.7 109.3
15 26.1 26.6 27.3 30.1 33.1 34.1 34.7 98.9 100.3 102.5 110.5 119.2 121.8 123.5
16 29.3 29.8 30.6 33.6 36.9 37.8 38.5 110.9 112.4 114.7 123.3 132.6 135.3 137.1
17 32.4 32.9 33.7 36.9 40.3 41.4 42.1 122.6 124.2 126.6 135.6 145.3 148.1 150.0
18 35.3 35.8 36.7 40.0 43.6 44.7 45.4 133.9 135.6 138.1 147.5 157.4 160.4 162.3
19 38.1 38.7 39.6 43.1 46.8 47.9 48.6 145.1 146.8 149.4 159.0 169.3 172.3 174.3
20 41.0 41.6 42.6 46.1 49.9 51.1 51.8 156.4 158.1 160.8 170.7 181.1 184.2 186.2
21 44.0 44.6 45.6 49.2 53.1 54.3 55.1 167.8 169.6 172.3 182.4 193.0 196.1 198.1
22 47.0 47.6 48.6 52.3 56.4 57.6 58.4 179.3 181.1 183.9 194.0 204.8 208.0 210.0
23 49.9 50.6 51.6 55.5 59.6 60.8 61.6 190.7 192.5 195.3 205.7 216.6 219.7 221.8
24 52.9 53.6 54.7 58.6 62.8 64.1 64.9 201.9 203.8 206.6 217.1 228.1 231.3 233.5
25 55.9 56.6 57.7 61.7 66.0 67.3 68.1 212.9 214.8 217.7 228.3 239.5 242.7 244.9
26 58.8 59.5 60.6 64.7 69.1 70.4 71.3 223.6 225.5 228.4 239.2 250.5 253.8 256.0
27 61.6 62.4 63.5 67.7 72.2 73.5 74.3 233.8 235.8 238.8 249.7 261.2 264.5 266.7
28 64.4 65.1 66.3 70.6 75.1 76.5 77.3 243.6 245.6 248.6 259.8 271.5 274.9 277.1
29 67.0 67.8 69.0 73.3 78.0 79.3 80.2 252.8 254.8 257.9 269.3 281.3 284.7 287.0
30 69.5 70.3 71.5 76.0 80.7 82.1 83.0 261.3 263.4 266.6 278.3 290.6 294.1 296.5
31 71.9 72.7 73.9 78.5 83.3 84.7 85.6 269.2 271.3 274.7 286.7 299.3 303.0 305.4
32 74.1 74.9 76.2 80.8 85.7 87.2 88.1 276.4 278.6 282.1 294.5 307.5 311.3 313.8
33 76.2 77.0 78.3 83.0 88.0 89.5 90.4 282.9 285.2 288.8 301.7 315.2 319.1 321.7
34 78.0 78.9 80.2 85.0 90.1 91.6 92.6 288.8 291.2 294.9 308.3 322.3 326.4 329.0
35 79.7 80.6 81.9 86.8 92.0 93.5 94.5 294.0 296.5 300.3 314.2 328.8 333.0 335.8
36 81.2 82.1 83.5 88.5 93.7 95.3 96.3 298.5 301.1 305.0 319.5 334.7 339.1 342.0
37 82.6 83.5 84.8 89.9 95.3 96.8 97.9 302.3 304.9 309.0 324.1 339.8 344.4 347.5
38 83.7 84.6 86.0 91.1 96.6 98.2 99.2 305.2 308.0 312.2 327.8 344.2 349.0 352.1
39 84.6 85.5 87.0 92.1 97.7 99.3 100.3 307.3 310.1 314.5 330.7 347.7 352.7 355.9
40 85.3 86.2 87.7 93.0 98.6 100.2 101.3 308.3 311.3 315.9 332.6 350.3 355.4 358.8
孕龄（周） 腹围（AC） 股骨长（FL）
3rd 5th 10th 50th 90th 95th 97th 3rd 5th 10th 50th 90th 95th 97th
10 30.9 31.5 32.4 36.0 40.0 41.2 42.0 1.6 1.7 1.8 2.2 2.6 2.8 2.9
11 39.2 39.9 41.1 45.4 50.1 51.6 52.5 2.9 3.0 3.2 3.8 4.6 4.8 5.0
12 48.4 49.2 50.6 55.7 61.3 63.0 64.1 4.7 4.9 5.1 6.1 7.2 7.6 7.8
13 58.3 59.3 60.9 66.8 73.3 75.2 76.5 7.0 7.3 7.6 8.9 10.5 11.0 11.3
14 68.8 70.0 71.8 78.4 85.7 87.9 89.4 9.8 10.0 10.5 12.2 14.2 14.8 15.3
15 79.7 81.0 83.0 90.4 98.5 100.9 102.5 12.7 13.1 13.6 15.7 18.1 18.8 19.3
16 90.8 92.2 94.3 102.5 111.3 113.9 115.6 15.7 16.1 16.8 19.1 21.9 22.7 23.3
17 101.8 103.3 105.7 114.5 123.9 126.8 128.6 18.7 19.1 19.8 22.4 25.4 26.3 26.9
18 112.9 114.5 117.0 126.3 136.4 139.4 141.4 21.4 21.9 22.6 25.4 28.5 29.5 30.1
19 123.8 125.5 128.1 138.0 148.7 151.8 153.9 24.1 24.6 25.3 28.2 31.5 32.4 33.1
20 134.6 136.4 139.2 149.6 160.8 164.1 166.3 26.7 27.2 28.0 31.0 34.3 35.3 36.0
21 145.3 147.2 150.2 161.1 172.8 176.3 178.6 29.4 29.9 30.7 33.8 37.1 38.1 38.8
22 155.9 157.9 161.0 172.4 184.6 188.2 190.6 32.1 32.6 33.4 36.5 39.9 40.9 41.5
23 166.2 168.3 171.5 183.4 196.2 200.0 202.5 34.7 35.2 36.0 39.1 42.5 43.6 44.2
24 176.3 178.4 181.8 194.3 207.6 211.5 214.1 37.2 37.7 38.6 41.7 45.1 46.2 46.8
25 186.1 188.4 191.9 204.9 218.8 222.9 225.6 39.6 40.2 41.0 44.2 47.7 48.7 49.4
26 195.7 198.1 201.8 215.4 229.9 234.2 237.0 42.0 42.5 43.4 46.6 50.1 51.2 51.8
27 205.2 207.6 211.5 225.8 241.0 245.5 248.4 44.2 44.8 45.7 49.0 52.5 53.5 54.2
28 214.5 217.1 221.2 236.1 252.1 256.8 259.9 46.3 46.9 47.8 51.2 54.8 55.9 56.6
29 223.9 226.7 230.9 246.7 263.4 268.4 271.7 48.4 49.0 49.9 53.4 57.1 58.2 58.9
30 233.4 236.3 240.8 257.3 275.0 280.3 283.7 50.4 51.0 51.9 55.5 59.3 60.4 61.1
31 242.8 245.8 250.5 268.0 286.7 292.3 295.9 52.3 52.9 53.9 57.5 61.4 62.6 63.4
32 252.0 255.2 260.2 278.7 298.5 304.3 308.2 54.1 54.7 55.7 59.5 63.5 64.7 65.5
33 260.9 264.3 269.6 289.1 310.1 316.3 320.4 55.8 56.5 57.5 61.4 65.6 66.8 67.6
34 269.5 273.1 278.7 299.3 321.4 328.0 332.3 57.5 58.1 59.2 63.2 67.5 68.8 69.6
35 277.6 281.4 287.3 309.0 332.4 339.3 343.9 59.0 59.8 60.9 65.0 69.4 70.7 71.5
36 285.2 289.2 295.4 318.3 342.9 350.3 355.1 60.6 61.3 62.4 66.7 71.2 72.5 73.4
37 292.4 296.6 303.1 327.2 353.2 360.9 366.0 62.0 62.7 63.9 68.3 72.9 74.2 75.1
38 299.4 303.7 310.6 335.9 363.2 371.4 376.8 63.3 64.1 65.3 69.7 74.5 75.9 76.8
39 306.2 310.7 317.9 344.5 373.4 382.0 387.7 64.5 65.3 66.6 71.1 76.0 77.4 78.3
40 312.9 317.7 325.2 353.3 383.8 392.9 398.9 65.6 66.4 67.7 72.4 77.4 78.9 79.9
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