Ultrasonography score in comparison with pelvic anterior posterior diameter for the prognostic evaluation of fetal hydronephrosis / 中华超声影像学杂志

Objective To determine whether prenatal ultrasonography (US) score is more effective than renal pelvic anterior posterior diameter (PAPD) for the prognostic evaluation of fetal hydronephrosis.Methods Fetuses with hydronephrosis (PAPD≥ 10 mm) were examined by prenatal US in the third trimester.PAPD,renal parenchyma thickness (RPT) and pelvicaliceal morphology (PM) were measured and graded from 0 to 3 score on the basis of severity of hydronephrosis,then the total US score of each kidney was obtained.According to the follow-up results after birth,all the cases were divided into two groups:physiological and pathological hydronephrosis.Via Z test,paired comparison was made to analyze area under the curve (AUC) of US score and each of the other three factors.Results Confirmed by postnatal US and other clinical examinations,of 198 kidneys (158 cases ) with hydronephrosis,139 (70.20％ ) were physiological hydronephrosis and 59 (29.80％ ) were pathological hydronephrosis.AUC of PAPD,RPT,PM,US score was 0.897 (minimum),0.957,0.944 and 0.982 (maximum) respectively,and there was significant difference between AUC of US score and each of the other three ( P ＜0.05).US score was the best approach for differential diagnosis of fetal hydronephrosis.Conclusions Prenatal US score is more effective and accurate than the single factor (PAPD,RPT,PM) to differentiate fetal physiological and pathological hydronephrosis.It was a new quantitative method to evaluate the prognosis of fetal hydronephrosis,and should be disseminated and applied clinically.

Clinical value and effectiveness of sonography screening for fetal chromosomal abnormalities in the middle and late pregnancy / 中华超声影像学杂志

Objective To evaluate the clinical value and effectiveness of ultrasound screening for fetal chromosomal abnormalitie in the middle and late pregnancy. Methods Fetuses who were detected with abnormal ultrasound findings during the middle and late pregnancy, and high risk of maternal serum screening underwent amnioeentesis or eordocentesis for fetal chromosome karyotypes. Results (1) A total of 31 cases with fetal malformation diagnosed by ultrasound were analysed for fetal chromosome karyotypes, and 8 (25.8%) cases were proved with fetal abnormal chromosome karyotypes. There were 3 cases of cervical springwater cyst accompany with edema,and all were fetal abnormal chromosome karyotypes. There were 3 cases of cervical pachyderma,and 2 were fetal abnormal chromosome karyotypes. There was one case with multiple malformations, one with Dandy-Walker malformation and one with holoprosencephaly malformation,all were revealed fetal abnormal chromosome karyotypes. (2) A total of 516 cases with high risk of Down's syndrome and trisomy 18 by maternal serum screening were analysed for fetal chromosome karyotypes,and 14(2.710%) cases were proved with fetal abnormal chromosome karyotypes, which include 7 cases of Down's syndrome and 7 cases of other fetal abnormal chromosome karyotypes. (3) A total of 544 (516 + 28)cases with high risk by the combination of ultrasound and maternal serum screening were analysed for fetal chromosome karyotypes, and 21 (3.86%) cases were proved with fetal abnormal chromosome karyotypes, the rate of detection higher than only maternal serum screening 42.43%.Conclusions Fetal structure abnormalities were the effective ultrasound signs for fetus chromosomal abnormalities screening in the middle and late pregnancy. The combination of ultrasound and maternal serum screening can improve the rate of fetus chromosomal abnormalities screening and be an effective way to retrieve false-positive and lower risk of maternal serum screening.

Study of the size and configuration of the third ventricle of the normal fetus in the second and third trimester by ultrasonography / 中华超声影像学杂志

Objective To observe the normal configuration and size of the third ventricle in the second and third trimester fetuses in a normal population by ultrasonography. Methods The third ventricular width and configuration were obtained by antenatal ultrasonography in 765 fetuses with gestational age between 27 weeks and term.The relationship Between the width and the gestational age was analyzed.Results The third ventricle width 0～3 mm and showed the increased tendency; the correlation coefficient ( r ) between the width of the third ventricle and the gestationl week was 0.473 ( P＜0.01).The third ventricle was seen as a single echogenic line in 8(4.8%) of 165 fetuses, 145(61.5%) of all fetuses had parallel echogenic lines outlining a fluid-filled lumen, the V-shaped configuration of the third ventricle was seen in 12(7.3%) of the fetuses.Conclusions The third ventricle width shows the increased tendency in the second and third trimester.The parallel echogenic line becomes the prominent ultrasonography appearance in the second and third trimester fetuses.It's usefull to observe the normal ultrasonic apperance of the third ventricle in diagnosing the fetal central nervous abnormities.

Application of interventional ultrasound to prenatal diagnosis of fetal chromosomal abnormalities / 中华超声影像学杂志

Objective To evaluate the role of interventional ultrasound technique in prenatal diagnosis of fetal chromosomal abnormalities.Methods Percutaneous ultrasound-monitored amniocentesis and cordocentesis were performed on 186 pregnant women with indicantions for prenatal diagnosis to detect karyotype of the fetus.Results All the cases were punctured successfully.Percutaneous ultrasound-monitored amniocentesis was performed in 105 pregnant women.The archievement rate of the aminiotic fluid was 97.1%,and the detection rate of the chromosomal abnormality was 8.8%.Percutaneous ultrasound-monitored cordocentesis were performed in 81 pregnant women.The archievement rate of the cord blood was 98.8%,and the detection rate of the chromosomal abnormality was 5.0%.There was no significant deviation between them.The valid indications of the puncture included the abnormal serology screening results of pregnant women,the history of abnormal deliveries,the history of the trisomy 21,and the abnormal fetus detected by ultrasound,the last of which was higher than the other indications at the detection of the chromosomal abnormality.Conclusions Interventional ultrasound technique proves to be valid in the prenatal diagnosis,and ultrasound detection of abnormal fetus indicates the possibility of the fetal chromosomal abnormality.

Ultrasonic diagnosis in fetal congenital absence of the radius / 中华超声影像学杂志

Objective To discuss the feature of the ultrasonic image of the fetal congenital absence of the radius. Methods Five cases with congenital absence of the radius were examined by colour Doppler sonography and compared with normal fetuses. Results There were four characteristics of ultrasonic imaging:①The length of three radius was 0 cm in the six disabled limbs,others were 4 time s shorter than the normal identical pregnant fetuses. ②All the disabled limbs showed that the forearm was short and bent, and the hand was lopsided. ③All the cases were combined with hydramnios. ④Three abnormal fetuses were combined with other deformies.Conclusions Ultrasound is superior to other methods in diagnosing fetus congenital absence of the radius.