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目的总结胎儿泪囊突出(DCC)的超声图像特征和产前超声诊断的临床价值。方法对在我院产前超声检查检出的14例先天性DCC的超声影像表现、合并异常及临床随访结果进行总结分析。结果胎儿先天性DCC超声图像表现:(1)胎儿眼眶内侧稍下方可见边界清晰的类圆形囊性病变,彩色多普勒超声显示囊性病变内无血流信号。(2)部分胎儿(4/14)囊性病变内可见点状强回声。(3)首次发现DCC时孕周为25~35周,平均27.6周。(4)以单侧和女性胎儿多见(9/14)。(5)单发泪囊突出多见(12/14)。(6)产前超声复查发现5例(5/14)泪囊突出消失。(7)2例(2/14)出生后出现泪囊炎,经抗生素治疗或泪囊探通术后缓解。其余12例出生后均无明显眼部症状。结论胎儿泪囊突出产前超声诊断准确,宫内缓解率高。胎儿DCC及合并异常应进行随访,对早期治疗有指导意义。
Objective To summarize the characteristics of ultrasound image and prenatal ultrasound in the diagnosis of fetal lacrimal sac (DCC). Methods 14 cases of congenital DCC detected by prenatal ultrasound in our hospital were analyzed retrospectively. Results of ultrasound imaging, combined abnormalities and clinical follow-up results were analyzed. Results Fetal congenital DCC ultrasound image performance: (1) within the fetal eye orbital slightly clear round cystic lesions seen, color Doppler ultrasound cystic lesions showed no blood flow signal. (2) part of the fetus (4/14) cystic lesions visible punctate strong echo. (3) When the first DCC was found, gestational weeks were 25-35 weeks, with an average of 27.6 weeks. (4) Unilateral and female fetuses more common (9/14). (5) single lacrimal sac prominent (12/14). (6) Prenatal ultrasound examination found that 5 cases (5/14) lacrimal sac prominent disappear. (7) Dacryocystitis occurred in 2 cases (2/14) after birth and was relieved after antibiotic treatment or exploration of dacryocyst. The remaining 12 cases were no obvious ocular symptoms after birth. Conclusions Fetal lacrimal sac prominent prenatal ultrasound diagnostic accuracy, intrauterine remission rate. Fetal DCC and combined abnormalities should be followed up, which is of guiding significance for early treatment.