产前三维超声诊断先天性马蹄内翻足及其评分方法的研究

摘要

目的 尝试应用一种新的产前超声评分方法来诊断和评价先天性马蹄内翻足.方法 对31例怀疑马蹄足胎儿(50只足)和62例常规产前检查胎儿(124只足)进行二维和三维超声检查.参照小儿马蹄足Pirani评分方法,结合超声所见中足和后足的形态进行综合评分.所有病例均在分娩后或引产后由临床医生作出最终诊断,分析超声所见的异常表现、产前超声评分与临床结果间的相关性.结果 通过三维重建的超声图像能够观察到马蹄足胎儿中足内缘折痕、外缘弯曲、空足跟及后足折痕四项异常表现.以上4种异常表现以及超声评分均与临床结果呈高度相关.结论 产前三维超声评分方法对诊断先天性马蹄内翻足有临床价值.%Objective To develop a new methodology of prenatal sonography scoring to assess and dignose clubfoot.Methods Thirty-one fetuses suspected clubfoot(50 foots) and 62 normal fetuses(124 foots) were scanned with both 2D and 3D sonography,and were divided into normal feet group and clubfeet group.Our scoring system was made according to the Pirani-scoring for children,while considering the morphology of mid-foot and hind-foot of infants.The doctors would give final diagnosis for all fetuses after delivery or induced labor,and analyse the correlations among the abnormal signs,sonographic score and the clinical outcomes.Results The curve lat border,the medial crease,the empty heel and the post crease can be observed in the 3D reconstruction images.These four abnormal signs had close correlations with the clinical results.Conclusions The new prenatal clubfeet scoring system by 3D sonography is a promising methodology with clinical values.