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中华妇幼临床医学杂志(电子版) ›› 2021, Vol. 17 ›› Issue (03) : 251 -256. doi: 10.3877/cma.j.issn.1673-5250.2021.03.002

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超声影像学:胎儿医学中的"眼睛"
罗红()   
  • 收稿日期:2021-05-02 修回日期:2021-05-20 出版日期:2021-06-01
  • 通信作者: 罗红

Ultrasound imaging: ″eyes″ in fetal medicine

Hong Luo()   

  • Received:2021-05-02 Revised:2021-05-20 Published:2021-06-01
  • Corresponding author: Hong Luo
  • Supported by:
    The 5th Sub-topic of National Key Research and Development Plan Project(2017YFC0113905)
引用本文:

罗红. 超声影像学:胎儿医学中的"眼睛"[J]. 中华妇幼临床医学杂志(电子版), 2021, 17(03): 251-256.

Hong Luo. Ultrasound imaging: ″eyes″ in fetal medicine[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2021, 17(03): 251-256.

胎儿医学是一个多学科团队协作平台,在参与胎儿医学平台建设的众多学科中,超声影像学以其安全、方便、经济、实时等优势,成为胎儿影像学检查的首选方法,是胎儿医学研究中的"眼睛"。超声诊断技术是产前筛查和诊断胎儿疾病的手段,其作用包括对胎儿出生缺陷的产前筛查与诊断、胎儿生长发育的超声监测、胎儿宫内储备能力的超声监测、复杂性双胎的超声诊断与监测等。在胎儿出生缺陷的产前筛查与诊断中,早孕期超声可进行胎儿染色体非整倍体筛查,相关指标主要为胎儿颈项透明层(NT)厚度;而产前诊断主要是指胎儿结构畸形的超声诊断,超声检查在胎儿疾病产前筛查领域的作用,已得到充分证实。超声影像学相关的产前诊断,还包括超声引导下胎儿穿刺术及活检术。产前筛查与诊断相关的超声影像学新技术蓬勃发展,包括三维容积超声技术、微血流成像技术、弹性成像技术等。超声在胎儿生长评估和异常生长筛查中起着重要作用。胎儿宫内储备能力的超声监测包括胎儿脐动脉、大脑中动脉、静脉导管等血管多普勒超声及胎儿生物物理评分。复杂性双胎产前超声检查包括对双胎绒毛膜性判断、复杂性双胎规范化检查、诊断和分型等。超声介入技术是对胎儿施行宫内治疗的媒介,涉及的胎儿治疗包括经羊膜腔治疗、介入治疗、外科手术治疗等。笔者拟就胎儿医学平台搭建中,超声影像学的价值及其最新发展现状进行阐述。

Fetal medicine is a multidisciplinary team collaboration platform. Among multiple-discipline participating in this platform, ultrasound imaging has become the preferred method for fetal imaging examination due to its advantages of safety, convenience, economy and real-time, and ultrasound imaging is the " eyes" in fetal medicine research. Fetal ultrasound diagnosis technology is a means of prenatal screening and diagnosis of fetal diseases, and its roles include prenatal screening and diagnosis of fetal birth defects, ultrasonic monitoring of fetal growth and development, ultrasonic monitoring of fetal intrauterine reserve capacity in utero, and ultrasonic diagnosis and monitoring of complex twins. In prenatal screening and diagnosis of fetal birth defects, ultrasound in the first trimester of pregnancy can be used to screen fetal chromosome aneuploidy, and relevant indicators mainly include nuchal translucency (NT) thickness. Prenatal diagnosis mainly refers to ultrasonic diagnosis of fetal structural malformations. The role of ultrasound examination in this field has been fully confirmed. Ultrasound-related prenatal diagnosis technologies also include ultrasound-guided fetal puncture and biopsy. New ultrasound technologies related to prenatal screening and diagnosis are developing rapidly, including three-dimensional volumetric ultrasound, microvascular imaging and elastography. Ultrasound plays an important role in fetal growth assessment and abnormal growth screening. Ultrasound monitoring of fetal intrauterine reserve capacity included Doppler ultrasonography of fetal umbilical artery, middle cerebral artery, and venous duct and other vessels as well as fetal biophysical score. Prenatal ultrasonography of complex twins includes judgment of chorionic properties of twins, standardized examination, diagnosis and classification of complex twins. Ultrasonic interventional technology is the medium of intrauterine treatment for fetus, which involves transamniotic cavity therapy, interventional therapy, surgical treatment, etc.. The author intends to elaborate on the value of ultrasound imaging it the establishment of fetal medicine platform and its latest development status.

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