【摘要】 目的 探讨B型超声检查对联体双胎的诊断价值。 方法 回顾性分析2008年—2010年产前诊断为联体双胎的8例孕妇B型超声声像图资料，总结其声像表现。 结果 对称性联体双胎8例， 其中胸腹部联体6例， 头部联体2例。 结论 产前B型超声检查能为联体双胎的诊断提供重要临床信息，并可做出不同类型的诊断。【Abstract】 Objective To evaluate the value of B-scan ultrasound in diagnosing conjoined twins. Methods Prenatal ultrasound diagnosis of eight cases of conjoined twins from 2008 to 2010 in West China Second University Hospital was retrospectively analyzed, and their ultrasonograhical performances were summarized. Results Eight cases of conjoined twins with symmetry were diagnosed by B-scan ultrasound, including six with thoraco-omphalodidymus, and two with cephalodymus. Conclusion Prenatal ultrasound can provide important information for diagnosis of conjoined twins, and perform differential diagnosis for different types.
【摘要】 目的 拟初步建立孕28~34周的双胎胎儿生长参数超声测量值的正常范围，比较晚孕期单、双胎妊娠胎儿的宫内生长发育模式。 方法 对2009年5月-2010年4月超声诊断为正常宫内双活胎、单活胎孕妇，采用超声测量胎儿相关生长发育指标，包括双顶径、头围、腹围、股骨长等，测量其中部分双胎的小脑横径并应用虚拟器官计算机辅助分析技术测量其小脑容积，比较晚孕期单、双胎胎儿生长发育的差异。 结果 ①自妊娠30周以后，双胎胎儿的双顶径发育速度比单胎胎儿延缓，单、双胎胎儿平均每周增长分别约2.3、1.7 mm；②自妊娠32周以后， 双胎胎儿的头围的发育速度比单胎胎儿延缓，单、双胎胎儿平均每周增长分别约6.7、5.8 mm；③自妊娠30周以后， 双胎胎儿的腹围的发育速度比单胎胎儿延缓，单、双胎胎儿平均每周增长分别约6.9、5.3 mm；④双胎胎儿股骨长从孕28~34周发育速度均较单胎胎儿缓慢，单、双胎胎儿平均每周增长分别约2.0、1.7 mm；⑤多元分析孕28~34周的双胎胎儿双顶径、头围、腹围和股骨长，相对于单胎胎儿而言，自28周起，双胎妊娠胎儿的生长发育较延缓；⑥自孕28~34周，双胎胎儿小脑横径、小脑容积与单胎胎儿无明显差异。 结论 双胎妊娠胎儿与单胎妊娠胎儿在晚孕期有着不同的生长发育规律。【Abstract】 Objective To initially establish the growth parameters of normal twin pregnancy in 28-34 gestational ages according to the ultrasound measurement, and to compare the intrauterine growth patterns between the singleton and twin pregnancy. Methods The relevant index of the twin pregnancy, including the biparietal diameter (BPD), femur length, head circumference (HC), abdominal circumference (AC), were measured. The transverse cerebellar diameter (TCD) was measured and the virtural organ computer-aided analysis was used to detect the fetal cerebellar volume (FCV). The intrauterine growth patterns between the singleton and twin pregnancy was compared. Results After the gestational age of 30 weeks, the mean values of BPD of the twins pregnancies (1.7 mm) were lower than those of the singleton pregnancies (2.3 mm). After the gestational age of 32 weeks, the mean value of HC of the twins pregnancies (5.8 mm) was lower than that of the singleton pregnancies (6.7 mm). After the gestational age of 30 weeks, the mean values of AC of the twins pregnancies (5.3 mm) were lower than those of the singleton pregnancies (6.9 mm). After the gestational age of 28 weeks, the mean value of FL of the twins pregnancies (1.7 mm) was lower than the singleton pregnancies (2.0 mm). After the gestational age of 28 weeks, the growth of twin pregnancy fetuses is more slowly. After the gestational age of 28-34 weeks, the differences in mean values of TCD and FCV between the twin pregnancy and singleton pregnancy was not significant. Conclusion The twin pregnancy and singleton pregnancy have different growth patterns in the third trimester pregnancy.
Objective To formulate an evidence-based conclusion concerning ultrasound screening for fetal malformations for a pregnant woman after 12 gestational weeks. Methods Based on the clinical problem of whether pregnant women need ultrasound screening for fetal malformations after 11-14 gestational weeks, we used “ultrasound or sonography and prenatal or fetal at first trimester or 11-14 weeks; ultrasound exposure; fetal development” as the keywords and searched The Cochrane Library (Issue 4, 2008), MEDLINE (1981 to 2008), ACP Journal Club (1991 to 2008), and BMJ Clinical Evidence (1999 to 2008) for systematic reviews, randomized controlled trials (RCTs) and controlled clinical trials. The methodological quality of the included studies was assessed to identify the current best evidence. Results Three systematic reviews, two RCTs and ten cohort studies were retrieved. The results showed ultrasound screening detected different fetal malformations in the first, second and third trimester. Not all of the fetal malformations could be detected through prenatal ultrasound screening. Nuchal translucency (NT) measurement as a tool for screening chromosomally abnormal fetuses and detecting fetal malformations by ultrasound proved to be effective if performed within 11-14 gestational weeks. The routine second trimester screening, however, could not be replaced by a detailed ultrasound examination at 11-14 gestational weeks. Most of the trials concluded that the effect of ultrasound on a fetus was not harmful. Conclusion The findings of this study should reassure physicians and parents alike that ultrasound screening is an appropriate option for the pregnant women after 12 gestational weeks.
Objective To determine the frequencies and patterns of gastrointestinal wall thickening at muti-slice computed tomography (MSCT) in patients with hepatic cirrhosis. Methods One hundred and nine patients with cirrhosis and 130 patients without cirrhosis for gastrointestinal wall thickening were retrospectively analyzed by the abdominal MSCT scans. The frequencies of wall thickening were determined in the cirrhosis patients and in those without cirrhosis. The segmental distribution, symmetry and enhancement pattern were evaluated in all patients with cirrhosis for gastrointestinal wall thickening. Results Gastrointestinal wall thickening was seen in 72 cases (66%) with cirrhosis patients and in 12 cases (9%) without cirrhosis patients (Plt;0.005). The jejunum and ascending colon were the most common sites of gastrointestinal wall thickening, which was involved in 32 and 31 patients respectively. The scans of 46 (64%) patients with gastrointestinal wall thickening showed multisegmental distribution. Gastrointestinal wall thickening was concentric and homogeneous in all patients with cirrhosis. Conclusion Gastrointestinal wall thickening is common in patients with hepatic cirrhosis. It frequently involves multiple segments. The jejunum and ascending colon are the most common sites of involvement. MSCT plays an invaluable role in diagnostic evaluation of bowel wall thickening in patients with hepatic cirrhosis.
ObjectiveTo evaluate the performance of nuchal translucency (NT) measurement in the first trimester of pregnancy as a marker for congenital heart defects (CHD). MethodsFrom January 2010 to December 2012, middle-low risk pregnant women were prospectively evaluated at the Department of Ultrasound in West China Second Hospital of Sichuan University about Nuchal translucency and echocardiography. ResultsNT measurements was performed in 2 443 women from 2 764 pregnancy women, and a total of 2 125 case could be used in data analysis. NT measurement >2.5 mm was found in 68 fetuses, and 11 cases were diagnosed as CHD (prevalence 5.2/1 000). The sensitivity and specificity of NT measurement >2.5 mm for CHD were 45.5% and 87%, respectively. ConclusionIncreasing nuchal translucency might increase the risk of CHD in fetuses, and could be used as a method to diagnosis CHD.
目的：评价宫腔声学造影(SHG)对子宫内膜息肉的诊断价值。方法：对临床拟诊宫内膜息肉的76例患者进行TVS、SHG及宫腔镜手术病理检查，并对结果进行分析。结果：以手术病理结果作为诊断金标准，内膜息肉48例，黏膜下肌瘤9例，内膜增生10例，宫腔内机化血凝块3例，正常内膜6例。SHG对子宫内膜息肉诊断的准确性为93.4%，敏感性为93.7%，特异性为92.8%。TVS对子宫内膜息肉诊断的准确性为59.2%，敏感性为81.2%，特异性为21.4%。两种方法对内膜息肉的诊断准确率比较有显著差异(χ2=5.45，P=0.019)。结论：宫腔声学造影准确率高，是诊断子宫内膜息肉的可靠方法。