胎儿生物学参数超声参考值专家共识——肾脏径线

doi:10.3877/cma.j.issn.1672-6448.2026.03.003

表1 胎儿肾脏径线测量方法^{[1，4，10-11]}

测量指标	测量切面	切面要求及观察内容	游标放置位置
RL	肾脏矢状切面	切面要求:显示左/右肾脏矢状切面观察内容：肾呈长圆形，肾皮质呈中低回声，包绕低回声髓质，中央高回声为集合系统。有尿液充盈的时候，集合系统表现为无回声。	肾脏上下两极间的最大距离
RPT	肾脏矢状切面		垂直于肾脏长轴，测量肾被膜内缘至肾窦高回声外缘间的最大距离
RAPD	双侧肾脏横切面	切面要求:显示双侧肾脏横切面。观察内容:双肾位于腹围平面略向下水平、脊柱两侧,显示双侧肾盂,形态及回声正常	与椎弓下缘连线垂直，测量肾脏前后方向（腹背方向）的最大距离
RTD			与RAPD垂直，测量肾脏左右方向的最大距离
APRPD			肾盂前后的最大距离

表1 胎儿肾脏径线测量方法^{[1，4，10-11]}

测量指标	测量切面	切面要求及观察内容	游标放置位置
RL	肾脏矢状切面	切面要求:显示左/右肾脏矢状切面观察内容：肾呈长圆形，肾皮质呈中低回声，包绕低回声髓质，中央高回声为集合系统。有尿液充盈的时候，集合系统表现为无回声。	肾脏上下两极间的最大距离
RPT	肾脏矢状切面		垂直于肾脏长轴，测量肾被膜内缘至肾窦高回声外缘间的最大距离
RAPD	双侧肾脏横切面	切面要求:显示双侧肾脏横切面。观察内容:双肾位于腹围平面略向下水平、脊柱两侧,显示双侧肾盂,形态及回声正常	与椎弓下缘连线垂直，测量肾脏前后方向（腹背方向）的最大距离
RTD			与RAPD垂直，测量肾脏左右方向的最大距离
APRPD			肾盂前后的最大距离

图1 胎儿肾脏径线超声测量切面、测量方法及模式图。图a为经左肾脏矢状切面测量肾脏长径和实质厚度；图b为图a对应的模式图；图c为经右肾脏矢状切面测量肾脏长径和实质厚度；图d为图c对应的模式图；图e为经双侧肾脏横切面测量肾脏宽径、厚径和肾盂前后径；图f为图e对应的模式图注：LK为左肾；RK为右肾；+1：肾脏长径；+2：肾脏实质厚度；+3：肾脏厚径；+4：肾脏宽径；+5：肾盂前后径

表2 胎儿肾脏径线超声测量切面及测量质控要点

测量切面	测量指标	质控要点
肾脏矢状切面	RL、RPT	（1）单侧肾矢状切面完整显示（2）肾脏轮廓可辨（3）肾内结构（肾实质和集合系统）可辨（4）经肾脏腹部矢状切面放大至超声图像区域50%以上
双肾水平横切面	RAPD、RTD和APRPD	（1）双侧肾脏轮廓可辨（2）肾门可辨（3）脊柱显示为横切面（4）经肾脏腹部横切面放大至超声图像区域50%以上

表2 胎儿肾脏径线超声测量切面及测量质控要点

测量切面	测量指标	质控要点
肾脏矢状切面	RL、RPT	（1）单侧肾矢状切面完整显示（2）肾脏轮廓可辨（3）肾内结构（肾实质和集合系统）可辨（4）经肾脏腹部矢状切面放大至超声图像区域50%以上
双肾水平横切面	RAPD、RTD和APRPD	（1）双侧肾脏轮廓可辨（2）肾门可辨（3）脊柱显示为横切面（4）经肾脏腹部横切面放大至超声图像区域50%以上

表3 单胎肾脏长径、宽径、厚径及实质厚度百分位数超声正常参考值（mm）^[1，4]

孕龄（周）	RL			RTD			RAPD			RPT
孕龄（周）	5^th	50^th	95^th	5^th	50^th	95^th	5^th	50^th	95^th	5^th	50^th	95^th
16	11.5	14.2	17.0	5.6	8.6	11.6	6.0	8.6	11.2	2.3	3.0	3.7
17	12.9	15.7	18.4	6.7	9.7	12.7	6.9	9.5	12.1	2.6	3.4	4.1
18	14.3	17.1	19.9	7.7	10.8	13.8	7.8	10.4	13.0	2.8	3.7	4.6
19	15.7	18.5	21.3	8.8	11.8	14.9	8.6	11.2	13.9	3.1	4.1	5.1
20	17.1	19.9	22.7	9.8	12.8	15.9	9.4	12.1	14.7	3.4	4.4	5.5
21	18.4	21.3	24.2	10.7	13.8	16.9	10.2	12.9	15.6	3.6	4.8	6.0
22	19.7	22.6	25.6	11.6	14.8	17.9	10.9	13.6	16.4	3.9	5.2	6.5
23	21.0	24.0	27.0	12.5	15.7	18.9	11.6	14.4	17.2	4.2	5.6	7.0
24	22.3	25.3	28.4	13.4	16.7	19.9	12.3	15.1	18.0	4.4	6.0	7.5
25	23.5	26.6	29.8	14.3	17.5	20.8	12.9	15.8	18.7	4.7	6.3	7.9
26	24.7	27.9	31.1	15.1	18.4	21.8	13.6	16.5	19.5	5.0	6.7	8.4
27	25.9	29.2	32.5	15.8	19.3	22.7	14.1	17.2	20.2	5.3	7.0	8.8
28	27.1	30.5	33.9	16.6	20.1	23.6	14.7	17.8	20.9	5.5	7.4	9.2
29	28.3	31.7	35.2	17.3	20.9	24.4	15.2	18.4	21.6	5.8	7.7	9.6
30	29.4	33.0	36.5	18.0	21.7	25.3	15.7	19.0	22.3	6.0	8.0	10
31	30.5	34.2	37.9	18.7	22.4	26.1	16.2	19.6	22.9	6.2	8.3	10.3
32	31.6	35.4	39.2	19.3	23.1	26.9	16.6	20.1	23.5	6.4	8.5	10.6
33	32.7	36.6	40.5	20.0	23.8	27.7	17.1	20.6	24.1	6.6	8.7	10.8
34	33.8	37.8	41.7	20.5	24.5	28.5	17.4	21.1	24.7	6.7	8.9	11.0
35	34.8	38.9	43.0	21.1	25.2	29.2	17.8	21.5	25.3	6.8	9.0	11.1
36	35.9	40.1	44.3	21.6	25.8	30.0	18.1	22.0	25.8	6.9	9.1	11.2
37	36.9	41.2	45.5	22.1	26.4	30.7	18.5	22.4	26.3	7.0	9.1	11.2
38	37.9	42.3	46.8	22.6	27.0	31.3	18.7	22.8	26.8	7.0	9.0	11.1
39	38.8	43.4	48.0	23.1	27.5	32.0	19.0	23.1	27.2	-	-	-
40	39.8	44.5	49.2	23.5	28.1	32.6	19.2	23.4	27.7	-	-	-
41	40.7	45.5	50.4	23.9	28.6	33.2	19.4	23.8	28.1	-	-	-

表3 单胎肾脏长径、宽径、厚径及实质厚度百分位数超声正常参考值（mm）^[1，4]

孕龄（周）	RL			RTD			RAPD			RPT
孕龄（周）	5^th	50^th	95^th	5^th	50^th	95^th	5^th	50^th	95^th	5^th	50^th	95^th
16	11.5	14.2	17.0	5.6	8.6	11.6	6.0	8.6	11.2	2.3	3.0	3.7
17	12.9	15.7	18.4	6.7	9.7	12.7	6.9	9.5	12.1	2.6	3.4	4.1
18	14.3	17.1	19.9	7.7	10.8	13.8	7.8	10.4	13.0	2.8	3.7	4.6
19	15.7	18.5	21.3	8.8	11.8	14.9	8.6	11.2	13.9	3.1	4.1	5.1
20	17.1	19.9	22.7	9.8	12.8	15.9	9.4	12.1	14.7	3.4	4.4	5.5
21	18.4	21.3	24.2	10.7	13.8	16.9	10.2	12.9	15.6	3.6	4.8	6.0
22	19.7	22.6	25.6	11.6	14.8	17.9	10.9	13.6	16.4	3.9	5.2	6.5
23	21.0	24.0	27.0	12.5	15.7	18.9	11.6	14.4	17.2	4.2	5.6	7.0
24	22.3	25.3	28.4	13.4	16.7	19.9	12.3	15.1	18.0	4.4	6.0	7.5
25	23.5	26.6	29.8	14.3	17.5	20.8	12.9	15.8	18.7	4.7	6.3	7.9
26	24.7	27.9	31.1	15.1	18.4	21.8	13.6	16.5	19.5	5.0	6.7	8.4
27	25.9	29.2	32.5	15.8	19.3	22.7	14.1	17.2	20.2	5.3	7.0	8.8
28	27.1	30.5	33.9	16.6	20.1	23.6	14.7	17.8	20.9	5.5	7.4	9.2
29	28.3	31.7	35.2	17.3	20.9	24.4	15.2	18.4	21.6	5.8	7.7	9.6
30	29.4	33.0	36.5	18.0	21.7	25.3	15.7	19.0	22.3	6.0	8.0	10
31	30.5	34.2	37.9	18.7	22.4	26.1	16.2	19.6	22.9	6.2	8.3	10.3
32	31.6	35.4	39.2	19.3	23.1	26.9	16.6	20.1	23.5	6.4	8.5	10.6
33	32.7	36.6	40.5	20.0	23.8	27.7	17.1	20.6	24.1	6.6	8.7	10.8
34	33.8	37.8	41.7	20.5	24.5	28.5	17.4	21.1	24.7	6.7	8.9	11.0
35	34.8	38.9	43.0	21.1	25.2	29.2	17.8	21.5	25.3	6.8	9.0	11.1
36	35.9	40.1	44.3	21.6	25.8	30.0	18.1	22.0	25.8	6.9	9.1	11.2
37	36.9	41.2	45.5	22.1	26.4	30.7	18.5	22.4	26.3	7.0	9.1	11.2
38	37.9	42.3	46.8	22.6	27.0	31.3	18.7	22.8	26.8	7.0	9.0	11.1
39	38.8	43.4	48.0	23.1	27.5	32.0	19.0	23.1	27.2	-	-	-
40	39.8	44.5	49.2	23.5	28.1	32.6	19.2	23.4	27.7	-	-	-
41	40.7	45.5	50.4	23.9	28.6	33.2	19.4	23.8	28.1	-	-	-

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Expert consensus on ultrasound reference ranges for fetal biometry: renal dimensions

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