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目的研究超声检查在11~13~(+6)w胎儿颅脑异常中的临床价值,提高检查的诊断率。方法选择2012年1月至2015年8月在我院建档并进行超声检查的单胎孕妇4628例。观察胎儿的主要形态结构,测量胎儿的颈项透明层厚度,重点观察胎儿的颅脑横切面,筛选出超声检查显示颅脑异常的胎儿。结果孕期为11~13~(+6)w胎儿颅脑超声检查结果显示,有39例胎儿的颅脑结构异常,检出率为0.84%,有33例胎儿因为严重畸形儿做引产处理,尸检结果证实胎儿确实为颅脑异常,其中无脑及露脑畸形23例,脑膜脑膨出5例,无叶全前脑3例,后颅窝明显扩大2例;其余6例胎儿为单纯脉络丛囊肿,均正常出生。孕11~13~(+6)w超声诊断颅脑结构异常比例最高(68.42%),中孕期系统超声检查其次(21.05%),晚孕期超声也能发现后期发生的胎儿颅脑异常(10.53%)。结论早孕期11~13~(+6)w胎儿系统超声检查可以筛查出部分早期发生的胎儿颅脑异常,对早期诊断胎儿颅脑的严重畸形有重要意义,但仍不能替代中晚孕期胎儿的超声检查,建立孕早、中、晚期连续动态筛查系统非常必要。
Objective To study the clinical value of ultrasonography in 11 ~ 13 ~ (+6) w fetal brain abnormalities and to improve the diagnostic rate of the examination. Methods 4628 singleton pregnant women who were filing in our hospital from January 2012 to August 2015 and who underwent ultrasound examination were selected. Observe the main morphological structure of the fetus, measure the thickness of the neck transparent layer of the fetus, focus on the fetal transverse section of the brain, and screen out the fetuses with abnormal brain manifestations by ultrasound examination. Results During pregnancy, 11 ~ 13 ~ (+6) w fetal brain ultrasound examination showed that 39 cases of fetal brain structure abnormalities, the detection rate was 0.84%, 33 cases of fetus because of severe malformations do induced abortion, autopsy The results confirmed that the fetus indeed brain abnormalities, including no brain and brain deformity in 23 cases, 5 cases of brain encephalocele, no leaf forehead in 3 cases, 2 cases of obvious enlargement of the posterior fossa; the remaining 6 cases of simple choroid plexus Cysts are normal birth. The proportion of abnormalities in the diagnosis of craniocerebral structures during the period of 11 ~ 13 ~ (+6) w pregnancies was the highest (68.42%), followed by ultrasound in the second trimester (21.05%), fetal abnormalities of late fetus (10.53% ). Conclusion Fetal ultrasound examination of 11 ~ 13 ~ (+6) w in early pregnancy can screen out part of early fetal brain abnormalities and is important for the early diagnosis of severe deformities in the fetal brain, but it still can not replace the fetuses in the second trimester of pregnancy Ultrasound examination, the establishment of early, middle and late continuous dynamic screening system is necessary.