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妇产科超声影像学

胎儿马蹄肾产前超声多切面扫查及动态观察与图像分析

  • 陈小辉 ,
  • 戴渝萍 ,
  • 夏洪彬 ,
  • 杨春江
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  • 1. 400020 重庆市人口和计划生育科学技术研究院附属医院超声科
    2. 400014 重庆医科大学附属儿童医院超声科
通讯作者:陈小辉,Email:
陈小辉,戴渝萍,夏洪彬,等.胎儿马蹄肾产前超声多切面扫查及动态观察与图像分析[J/CD].中华医学超声杂志:电子版, 2016, 13(11): 861-864.

收稿日期: 2016-09-23

  网络出版日期: 2016-11-01

Prenatal ultrasound multi-slice scanning, dynamic observation and image analysis of fetal horseshoe kidney

  • Xiaohui Chen ,
  • Yuping Dai ,
  • Yongbin Xia ,
  • Chunjiang Yang
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  • 1. Department of Ultrasound, the Affiliated Hospital of Chongqing Population and Family Planning Science and Technology Research Institute, Chongqing 400020, China
    2. Department of Ultrasound, the Children's Hospital Affiliated Chongqing University of Medical Science, Chongqing 400014, China
Corresponding author: Chen Xiaohui, Email:

Received date: 2016-09-23

  Online published: 2016-11-01

摘要

目的

探讨胎儿马蹄肾的产前超声声像图特征。

方法

2010年1月至2013年12月在重庆市人口和计划生育科学技术研究院附属医院行产前系统超声检查的胎儿12 021例,经多切面扫查及动态观察诊断马蹄肾15例(0.12%,15/12 021),与产后超声或MRI复查、尸检和临床随访结果对照,对15例马蹄肾胎儿产前超声声像图特征进行分析。

结果

15例胎儿首次超声扫查检出马蹄肾6例,间隔4~6周后复查补充检出马蹄肾9例。15例马蹄肾胎儿矢状切面扫查显示10例双肾位置较正常胎儿肾脏偏低、肾下极边界模糊;横切面连续扫查显示15例双肾下极均于脊柱前方融合呈特征性"马蹄"状;冠状切面连续扫查至脊柱前方均直观显示双肾下极融合。15例马蹄肾胎儿超声检查后出生11例,男性7例(伴发隐睾1例)、女性4例,产后超声(6例)及MRI复查(5例)均证实为马蹄肾,无肾外畸形;1例马蹄肾胎儿为18-三体综合征;其余3例均合并肾外畸形,超声检查后均终止妊娠;1例合并心脏室间隔缺损,染色体检查为21-三体综合征,2例合并肾外畸形(开放性脊柱裂和足内翻,尸检证实合并水平肝1例;生殖器畸形1例),染色体检查无异常。

结论

产前超声多切面扫查及动态观察结合染色体检查可及早发现胎儿马蹄肾及其合并畸形,以减少多发畸形胎儿的出生。

本文引用格式

陈小辉 , 戴渝萍 , 夏洪彬 , 杨春江 . 胎儿马蹄肾产前超声多切面扫查及动态观察与图像分析[J]. 中华医学超声杂志(电子版), 2016 , 13(11) : 861 -864 . DOI: 10.3877/cma.j.issn.1672-6448.2016.11.013

Abstract

Objective

To investigate the prenatal ultrasound image characteristics of fetal horseshoe kidney.

Methods

From January 2010 to December 2013, prenatal ultrasound examinations were performed on 12 021 cases at the Chongqing Population and Family Planning Science and Technology Research Institute through fetal multi-slice scanning and dynamic observation. Among these cases, 15 cases were diagnosed with horseshoe kidney (0.12%, 15/12 121). The postpartum ultrasound or MRI reviews, autopsy and clinical follow-up results of these 15 horseshoe kidney cases were compared with their fetal prenatal sonographic characteristics.

Results

Among the 15 horseshoe kidney cases, six horseshoe kidney cases were initially detected through fetal scanning. After an interval of 4-6 weeks, the remaining nine horseshoe kidney cases were detected by supplemental review. In the 15 horseshoe kidney cases, fetal kidney sagittal scans revealed that the renal locations were lower than those of normal fetal kidneys in 10 cases, and the lower border of the kidneys were fuzzy. In these 15 cases, cross-section continuous scans revealed a "horseshoe" shape characteristic of fusion kidneys in front of the spine. Coronal section scans revealed fusion kidneys at the front of the spine. Among the 15 horseshoe kidney cases, 11 cases were born after fetal ultrasound examination; in which seven cases were male (one case was associated with cryptorchidism) and four cases were female. Postpartum ultrasound (six cases) and MRI review (five cases) confirmed the horseshoe kidney, and no renal abnormalities were found. Furthermore, one horseshoe kidney case had trisomy 18 syndrome. Pregnancy was terminated for the three remaining cases associated with extra-renal malformations detected by ultrasound examination. One case had a ventricular septal defect and chromosome examination revealed trisomy 21 syndrome. Two cases had renal abnormalities (open spina bifida and foot varus diagnosed by ultrasound and horizontal liver confirmed by autopsy in one case, and genital deformity in the other case), and chromosome examination did not reveal any abnormalities.

Conclusion

Prenatal ultrasound multi-slice scanning and dynamic observation combined with chromosome examination and the early detection of fetal horseshoe kidney and its merger deformity can reduce multiple birth defects of the fetus.

参考文献

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