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目的探讨连续顺序追踪法和三维超声体表成像技术在诊断胎儿足内翻中的应用价值。方法在12000例胎儿系统筛查中,利用连续顺序追踪法检查胎儿四肢,选取15例可疑足内翻者,再进行小腿及足部三维重建,如果胎儿足底平面与小腿的长轴切面在同一平面显示,并且这种关系不因胎儿下肢的运动而变化,即可诊断为足内翻。结果 15例超声诊断足内翻的胎儿,经随访8例合并其他复杂畸形引产。出生7例中,4例足月产足内翻胎儿经石膏固定后恢复正常;1例足月产足内翻胎儿经石膏固定后未见好转,需择期手术治疗;1例足月产足内翻胎儿合并单心房出生1周后死亡;1例单侧单纯足内翻生后检查正常。结论胎儿足内翻畸形的主要诊断方法是连续顺序追踪法,三维彩超更能立体地显示胎儿踝部结构,2者联合应用,可提高足内翻的检出率。
Objective To investigate the value of continuous sequential tracing and three-dimensional surface ultrasonography in the diagnosis of fetal varus. Methods In 12000 fetal system screening, fetal limbs were examined by continuous sequential tracing method. Fifteen cases of suspicious foot varus were selected, and three-dimensional reconstructions of lower leg and foot were performed. If the long axis of fetus plantar plane and lower leg were in the same Plane display, and this relationship does not change due to fetal movement of the lower extremities, can be diagnosed with varus. Results Fifteen cases of fetus with foot varus were diagnosed by ultrasound and followed up for 8 cases with other complicated deformities. Born in 7 cases, 4 cases of full-term foot varus fetus returned to normal after gypsum fixation; 1 case of full-term foot varus fetus fixed after gypsum did not improve, requiring elective surgery; 1 case of full-term foot Fetal unilateral atrial fibrillation was born after 1 week and died; 1 case of unilateral simple pronucleus test was normal. Conclusion The main diagnostic method of fetal varus deformity is continuous sequential tracing method. Three-dimensional ultrasound can display the fetal ankle structure more stereoscopically. The combination of the two can improve the detection rate of varus valgus.