[摘要]目的:探讨超声诊断胎儿肾发育畸形的检查方法、声像图特征和临床意义。方法:从孕期超声检查的近3万名孕妇中共检出53例胎儿肾发育畸形,对检出结果进行分析。结果:各种胎儿肾畸形的声像图特征不同。本组胎儿肾畸形:肾积水27例,多囊肾3例,多房性肾囊性变8例,孤立性肾囊肿1例,肾发育不良7例,肾不发育5例,异位肾2例。结论:超声检查可发现多种胎儿肾发育畸形,是一种良好的产前诊断方法。 Abstract: Objective Inquiry into a super voice diagnosis an embryo's kidney to develop an abnormality check method, voice to be like diagram characteristic and clinical meaning. Method Check 53 embryo of kidney growth abnormal totally from theexpect a super voice 30,000 near pregnant womans for checking, carry on analysis towards checking as a result. Result The voice of various embryo kidney abnormal is like a diagram characteristic a dissimilarity.This embryo's kidney abnormal:The kidney accumulates water 27, many bag kidney is 3, having another the building scrotum to change 8, the isolation scrotum is swollen 1, kidney growth is bad 7, the kidney doesn't develop 5, the different kidney is 2. Conclusion The super voice check can discover various embryo kidney growth abnormal, is a kind of good prenatal period to diagnose a method. Key words: Embryo; Kidney abnormal; The super voice diagnoses 肾发育畸形临床常见,类型也较多,但由于多数畸形在胎儿期不易检出,以往超声诊断胎儿肾畸形的报道不多。随着近年来超声诊断仪器性能的不断改进,对胎儿先天性肾畸形的检出率逐渐增高。我站自1991年至2000年从孕期超声检查的近3万名孕妇中共检出胎儿肾畸形53例,本研究对超声诊断胎儿肾畸形的检查方法、声像图特征和临床意义进行初步探讨。 1 资料与方法 中晚期妊娠妇女53例,其中1例为双胎妊娠,余52例为单胎妊娠。孕妇平均年龄(28.3±2.99)岁,平均孕周(28.9±5.66)周。使用GE公司LOGIQ400MR型彩超,凸阵探头,使用频率3.5 MHz~7.0 MHz。孕妇取仰卧位,必要时可取侧卧位,常规观察胎儿躯体、胎盘及羊水状况,根据胎方位确认胎儿左右肾,详细观察肾脏位置、大小、形态和内部结构,输尿管有无扩张,膀胱是否充盈等。异常图像用录像机记录或视频打印机打印。 2 结果 53例胎儿肾发育畸形均经产后或引产后证实,结果见表1。 表1 53例胎儿肾发育畸形的超声检出结果(略) 胎儿肾发育畸形的声像图特征:肾积水,表现为单侧或双侧肾脏增大,轮廓尚整齐,肾实质变薄,集合系统回声分离,液性暗区多呈“花朵”状或“烟斗”状。本组有6例单侧肾积水和2例双侧肾积水合并输尿管扩张,其走行方向迂曲并延伸至膀胱,用彩色多普勒超声或能量多普勒超声检查,迂曲走行的管状液性暗区内无彩色血流信号显示;多囊肾,表现为双肾增大,近似球状,轮廓不光滑,实质回声增强,皮髓质及肾窦界限不清;多房性肾囊性变8例,均为单侧,其中左肾5例,右肾3例。超声显示患肾明显增大,形态失常,肾表面呈波浪状,实质内见大小不等的液性暗区,输尿管不扩张,健侧肾回声多正常;孤立性肾囊肿,肾实质见一圆形无回声区或患肾位置处仅见一巨大无回声区,壁光滑;肾发育不良,单侧肾发育不良表现为患肾小于正常,实质回声增强,皮髓质及肾窦界限不清,健侧肾脏大小、形态正常,羊水量可正常。双肾发育不良时,双肾均小于正常,膀胱充盈差,羊水少;肾不发育,双肾不发育胎儿胸腹腔内均不能探及肾脏回声,双侧肾上腺可显示,膀胱不充盈,羊膜腔内无羊水无回声区。单侧肾不发育,健侧肾脏大小正常或轻度增大,胎儿胸腹腔内均不能探及另一肾脏,患侧肾上腺可探及;异位肾2例,均为单侧,患侧肾区探测不到肾脏回声,2例肾脏均异位于盆腔。 3 讨论 [参考文献]
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