2025 , Vol. 22 >Issue 04: 283 - 288
DOI: https://doi.org/10.3877/cma.j.issn.1672-6448.2025.04.001
胎儿生物学参数超声参考值专家共识——孕龄
Copy editor: 汪荣
收稿日期: 2025-03-12
网络出版日期: 2025-06-09
基金资助
国家重点研发计划(2024YFC2707003)重庆市科卫联合医学科研重大项目(2024DBXM006)
版权
Expert consensus on ultrasound reference values for fetal biometry:gestational age
Received date: 2025-03-12
Online published: 2025-06-09
Copyright
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——孕龄[J]. 中华医学超声杂志(电子版), 2025 , 22(04) : 283 -288 . DOI: 10.3877/cma.j.issn.1672-6448.2025.04.001
表1 CRL 的测量方法 |
| 测量孕龄 | 测量切面 | 切面要求及观察内容 | 游标放置位置 |
|---|---|---|---|
| 8 ~ 10+6 周 | 胎儿矢状切面 | 胚胎/ 胎儿长轴与超声声束呈90°;放大感兴趣区域图像,直至头部和臀部的边界清晰可见 | 测量头与臀部之间的最长距离,不包括四肢和卵黄囊 |
| 11 ~ 13+6 周 | 胎儿正中矢状切面 | 胎儿仰卧,处于自然伸展姿势(胎儿长轴与超声声束呈90°,过度屈曲或过度伸展不宜测量);沿胎儿长轴取正中矢状切面,显示前额、鼻前皮肤、鼻骨、鼻尖,背部显示脊柱;头顶部、骶尾部皮肤及生殖结节清晰显示,躯干部显示脊柱矢状面全长;感兴趣区图像放大至超声图像区域2/3 以上 | 测量游标置于胎儿头顶皮肤外缘至骶尾部皮肤外缘,测量最大直线距离 |
注:CRL 为头臀长 |
表2 CRL 测量相关切面的质控要点 |
| 测量孕龄 | 质控要点 |
|---|---|
| 8 ~ 10+6 周 | ①胎儿/ 胚胎的头部和臀部可识别 |
| ②测量头与臀部之间的最长距离,不包括四肢和卵黄囊 | |
| 11 ~ 13+6 周 | ①胎儿仰卧,处于自然伸展姿势 |
| ②正中矢状切面,显示前额、鼻前皮肤、鼻骨、鼻尖 | |
| ③矢状切面显示躯干部全长 | |
| ④头顶部、骶尾部清晰显示 | |
| ⑤感兴趣区图像放大至超声图像区域 2/3 以上 |
注:CRL 为头臀长 |
表3 基于头臀长值估算孕龄[14] |
| CRL(mm) | 孕龄(周) |
|---|---|
| 15 | 8+3 |
| 16 | 8+3 |
| 17 | 8+4 |
| 18 | 8+5 |
| 19 | 8+6 |
| 20 | 8+6 |
| 21 | 9+0 |
| 22 | 9+1 |
| 23 | 9+1 |
| 24 | 9+2 |
| 25 | 9+3 |
| 26 | 9+3 |
| 27 | 9+4 |
| 28 | 9+5 |
| 29 | 9+5 |
| 30 | 9+6 |
| 31 | 10+0 |
| 32 | 10+0 |
| 33 | 10+1 |
| 34 | 10+2 |
| 35 | 10+2 |
| 36 | 10+3 |
| 37 | 10+3 |
| 38 | 10+4 |
| 39 | 10+5 |
| 40 | 10+5 |
| 41 | 10+6 |
| 42 | 10+6 |
| 43 | 11+0 |
| 44 | 11+1 |
| 45 | 11+1 |
| 46 | 11+2 |
| 47 | 11+2 |
| 48 | 11+3 |
| 49 | 11+4 |
| 50 | 11+4 |
| 51 | 11+5 |
| 52 | 11+5 |
| 53 | 11+6 |
| 54 | 11+6 |
| 55 | 12+0 |
| 56 | 12+1 |
| 57 | 12+1 |
| 58 | 12+2 |
| 59 | 12+2 |
| 60 | 12+3 |
| 61 | 12+3 |
| 62 | 12+4 |
| 63 | 12+4 |
| 64 | 12+5 |
| 65 | 12+6 |
| 66 | 12+6 |
| 67 | 13+0 |
| 68 | 13+0 |
| 69 | 13+1 |
| 70 | 13+1 |
| 71 | 13+2 |
| 72 | 13+2 |
| 73 | 13+3 |
| 74 | 13+3 |
| 75 | 13+4 |
| 76 | 13+4 |
| 77 | 13+5 |
| 78 | 13+6 |
| 79 | 13+6 |
| 80 | 14+0 |
| 81 | 14+0 |
| 82 | 14+1 |
| 83 | 14+1 |
| 84 | 14+2 |
| 85 | 14+2 |
| 86 | 14+3 |
| 87 | 14+3 |
| 88 | 14+4 |
| 89 | 14+4 |
| 90 | 14+5 |
| 91 | 14+5 |
| 92 | 14+6 |
| 93 | 14+6 |
| 94 | 15+0 |
| 95 | 15+0 |
注:CRL 为头臀长;表中孕龄为基于CRL 估算的第50 百分位数(中位数) |
表4 基于超声测量指标估算孕龄的推荐公式 |
| 指标类别 | 推荐公式 |
|---|---|
| 早孕期 | |
| CRL[14] | GA =[40.9041+ (3.21585 ×CRL0.5 ) +(0.348956 ×CRL)] / 7 |
| 中晚孕期 | |
| HC[19] | GA=6.395595 + 0.966476×(HC /10) - 0.019933×(HC /10)2 + 0.00059×(HC /10)3 |
| BPD[19] | GA=7.996225 + 2.277074×(BPDoi /10) + 0.025×(BPDoi /10)2 + 0.008007×(BPDoi /10)3 |
| FL[19] | GA11.52821+1.591733×(FL /10) + 0.435641×(FL /10)2 - 0.017006×(FL/10)3 |
| TCD[20] | GA=3.957113 + 8.154074×(TCD /10) - 0.076187×((TCD /10)3 ) |
| FoL[21] | GA=7 + 0.42× FoL |
| HC+FL [10] | GA=e[0.03243×(loge (HC))2+0.001644×FL×loge (HC)+3.813 ]/ 7 |
| BPD+HC+AC+FL[22] | GA10.6 - 0.168× BPD + 0.045× HC + 0.03× AC + 0.058× FL + 0.002× BPD2 + 0.002× FL2 +0.0005×(BPD× AC) - 0.005×(BPD× FL) - 0.0002×(HC × AC) + 0.0008×( HC × FL) + 0.0005× (AC × FL) |
注:GA 为孕龄,单位为周;CRL 为头臀长;HC 为头围;BPD 为双顶径;BPDDoi 为经“外-内”测量的双顶径;FL 为股骨长;TCD 为小脑横径;FoL 为足长;AC 为腹围;以上超声测量指标(CRL、HC、BPD、AC、FL、TCD、FoL)的单位均为mm。以上算法已集成于“优生智算”微信小程序在线计算平台,以便于使用 |
表5 基于单一测量指标估算孕龄[19-21] |
| HC(mm) | 孕龄(周) | BPD(mm) | 孕龄(周) | FL(mm) | 孕龄(周) | TCD(mm) | 孕龄(周) | FoL(mm) | 孕龄(周) |
|---|---|---|---|---|---|---|---|---|---|
| 80 | 13+2 | 20 | 12+5 | 10 | 13+4 | 12 | 13+5 | 12 | 12+0 |
| 85 | 13+4 | 21 | 13+0 | 11 | 13+6 | 13 | 14+3 | 13 | 12+4 |
| 90 | 13+7 | 22 | 13+2 | 12 | 14+0 | 14 | 15+2 | 14 | 12+7 |
| 95 | 14+3 | 23 | 13+4 | 13 | 14+3 | 15 | 15+7 | 15 | 13+3 |
| 100 | 14+5 | 24 | 13+5 | 14 | 14+5 | 16 | 16+5 | 16 | 13+5 |
| 105 | 15+0 | 25 | 14+0 | 15 | 14+6 | 17 | 17+3 | 17 | 14+1 |
| 110 | 15+3 | 26 | 14+2 | 16 | 15+1 | 18 | 18+2 | 18 | 14+5 |
| 115 | 15+6 | 27 | 14+4 | 17 | 15+3 | 19 | 18+7 | 19 | 14+0 |
| 120 | 16+1 | 28 | 14+5 | 18 | 15+5 | 20 | 19+5 | 20 | 15+3 |
| 125 | 16+4 | 29 | 15+0 | 19 | 16+0 | 21 | 20+3 | 21 | 15+6 |
| 130 | 16+7 | 30 | 15+3 | 20 | 16+3 | 22 | 21+1 | 22 | 16+2 |
| 135 | 17+3 | 31 | 15+4 | 21 | 16+5 | 23 | 21+6 | 23 | 16+5 |
| 140 | 17+5 | 32 | 15+6 | 22 | 17+0 | 24 | 22+4 | 24 | 17+1 |
| 145 | 18+0 | 33 | 16+1 | 23 | 17+3 | 25 | 23+2 | 25 | 17+4 |
| 150 | 18+3 | 34 | 16+3 | 24 | 17+5 | 26 | 23+6 | 26 | 17+7 |
| 155 | 18+6 | 35 | 16+5 | 25 | 18+0 | 27 | 24+4 | 27 | 18+3 |
| 160 | 19+2 | 36 | 16+7 | 26 | 18+3 | 28 | 25+1 | 28 | 18+6 |
| 165 | 19+5 | 37 | 17+2 | 27 | 18+5 | 29 | 25+5 | 29 | 19+2 |
| 170 | 20+0 | 38 | 17+4 | 28 | 19+0 | 30 | 26+3 | 30 | 19+5 |
| 175 | 20+3 | 39 | 17+5 | 29 | 19+3 | 31 | 27+0 | 31 | 20+0 |
| 180 | 20+6 | 40 | 18+0 | 30 | 19+6 | 32 | 27+5 | 32 | 20+3 |
| 185 | 21+2 | 41 | 18+3 | 31 | 20+1 | 33 | 28+1 | 33 | 20+7 |
| 190 | 21+5 | 42 | 18+5 | 32 | 20+4 | 34 | 28+5 | 34 | 21+3 |
| 195 | 22+0 | 43 | 18+7 | 33 | 20+7 | 35 | 29+2 | 35 | 21+5 |
| 200 | 22+4 | 44 | 19+2 | 34 | 21+3 | 36 | 29+6 | 36 | 22+1 |
| 205 | 22+7 | 45 | 19+4 | 35 | 21+5 | 37 | 30+3 | 37 | 22+4 |
| 210 | 23+3 | 46 | 19+6 | 36 | 22+1 | 38 | 30+6 | 38 | 23+0 |
| 215 | 23+6 | 47 | 20+1 | 37 | 22+4 | 39 | 31+2 | 39 | 23+3 |
| 220 | 24+3 | 48 | 20+3 | 38 | 22+7 | 40 | 31+5 | 40 | 23+6 |
| 225 | 24+6 | 49 | 20+5 | 39 | 23+3 | 41 | 32+1 | 41 | 24+2 |
| 230 | 25+3 | 50 | 21+0 | 40 | 23+6 | 42 | 32+5 | 42 | 24+5 |
| 235 | 25+6 | 51 | 21+3 | 41 | 24+2 | 43 | 33+0 | 43 | 25+1 |
| 240 | 26+3 | 52 | 21+5 | 42 | 24+5 | 44 | 33+3 | 44 | 25+4 |
| 245 | 26+6 | 53 | 22+0 | 43 | 25+1 | 45 | 33+5 | 45 | 25+7 |
| 250 | 27+3 | 54 | 22+3 | 44 | 25+4 | 46 | 34+1 | 46 | 26+3 |
| 255 | 27+7 | 55 | 22+5 | 45 | 26+0 | 47 | 34+3 | 47 | 26+5 |
| 260 | 28+3 | 56 | 22+7 | 46 | 26+3 | 48 | 34+5 | 48 | 27+2 |
| 265 | 29+0 | 57 | 23+3 | 47 | 26+7 | 49 | 34+7 | 49 | 27+5 |
| 270 | 29+5 | 58 | 23+5 | 48 | 27+3 | 50 | 35+2 | 50 | 28+0 |
| 275 | 30+2 | 59 | 24+0 | 49 | 27+6 | 51 | 35+3 | 51 | 28+3 |
| 280 | 30+6 | 60 | 24+3 | 50 | 28+3 | 52 | 35+5 | 52 | 28+6 |
| 285 | 31+3 | 61 | 24+5 | 51 | 28+5 | 53 | 35+6 | 53 | 29+3 |
| 290 | 32+0 | 62 | 25+0 | 52 | 29+2 | 54 | 36+0 | 54 | 29+5 |
| 295 | 32+5 | 63 | 25+3 | 53 | 29+5 | 55 | 36+1 | 55 | 30+1 |
| 300 | 33+3 | 64 | 25+5 | 54 | 30+1 | 56 | 30+4 | ||
| 305 | 34+1 | 65 | 26+1 | 55 | 30+5 | 57 | 30+7 | ||
| 310 | 34+6 | 66 | 26+3 | 56 | 31+1 | 58 | 31+3 | ||
| 315 | 35+4 | 67 | 26+6 | 57 | 31+5 | 59 | 31+6 | ||
| 320 | 36+2 | 68 | 27+2 | 58 | 32+1 | 60 | 32+2 | ||
| 325 | 37+0 | 69 | 27+4 | 59 | 32+5 | 61 | 32+5 | ||
| 330 | 37+6 | 70 | 27+7 | 60 | 33+1 | 62 | 33+0 | ||
| 335 | 38+5 | 71 | 28+3 | 61 | 33+5 | 63 | 33+4 | ||
| 340 | 39+3 | 72 | 28+5 | 62 | 34+1 | 64 | 33+7 | ||
| 345 | 40+2 | 73 | 29+1 | 63 | 34+5 | 65 | 34+3 | ||
| 350 | 41+1 | 74 | 29+4 | 64 | 35+1 | 66 | 34+5 | ||
| 355 | 42+0 | 75 | 29+7 | 65 | 35+5 | 67 | 35+1 | ||
| 360 | 42+7 | 76 | 30+3 | 66 | 36+1 | 68 | 35+5 | ||
| 77 | 30+5 | 67 | 36+5 | 69 | 36+0 | ||||
| 78 | 31+1 | 68 | 37+1 | 70 | 36+3 | ||||
| 79 | 31+4 | 69 | 37+5 | 71 | 36+6 | ||||
| 80 | 31+7 | 70 | 38+2 | 72 | 37+2 | ||||
| 81 | 32+3 | 71 | 38+5 | 73 | 37+5 | ||||
| 82 | 32+6 | 72 | 39+2 | 74 | 38+1 | ||||
| 83 | 33+2 | 73 | 39+5 | 75 | 38+4 | ||||
| 84 | 33+5 | 74 | 40+3 | 76 | 38+7 | ||||
| 85 | 34+1 | 75 | 40+6 | 77 | 39+3 | ||||
| 86 | 34+4 | 76 | 41+3 | 78 | 39+6 | ||||
| 87 | 35+0 | 77 | 41+6 | 79 | 40+2 | ||||
| 88 | 35+3 | 78 | 42+3 | 80 | 40+5 | ||||
| 89 | 35+7 | 79 | 42+7 | 81 | 41+0 | ||||
| 90 | 36+3 | 82 | 41+3 | ||||||
| 91 | 36+6 | ||||||||
| 92 | 37+3 | ||||||||
| 93 | 37+6 | ||||||||
| 94 | 38+3 | ||||||||
| 95 | 38+6 | ||||||||
| 96 | 39+3 | ||||||||
| 97 | 39+6 | ||||||||
| 98 | 40+3 | ||||||||
| 99 | 40+6 | ||||||||
| 100 | 41+3 |
注:HC 为头围;BPD 为双顶径;FL 为股骨长;TCD 为小脑横径;FoL 为足长;所估算孕龄为第50 百分位数(中位数);孕龄均根据参考文献中的公式估算而得 |
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