三维超声对中晚孕期胎儿肾脏监测的临床价值
发布时间：2018-07-31 09:20
【摘要】：目的 本课题旨在探讨三维超声TUI(Tomographic Ultrasound Imaging)和VOCAL(Virtual Organ Computer aided Analysis)技术动态监测不同孕周正常胎儿肾脏长径、横径、前后径及体积的变化，为胎儿肾脏的异常发育及时提供线索。探讨胎儿肾脏长径、横径、前后径和体积与孕周的相关性。追踪胎儿肾盂前后径超过正常范围时的不同转归。 研究方法 筛选2012年9月至2013年12月在山西医科大学附属第一临床医院妇产科超声室行常规超声检查的肾盂宽度在0-10mm之间的正常胎儿186例，使用三维超声扫查肾脏，采用三维超声TUI技术测量胎儿肾脏的长径、横径及前后径，采用三维超声VOCAL技术测量肾脏体积。 收集病例期间对二维超声检查单侧肾盂前后径(PAPD, Pelvic anteriorposterior diameter)≥10mm的30例胎儿进行随访，使用三维超声TUI及VOCAL技术观察、测量并记录肾盂前后径（PAPD）、肾实质的厚度(RPT, Renalparenchyma thickness)、肾门肾动脉的阻力指数（RI, Resistance index）及肾盂的体积。 结果 一、三维TUI技术测量胎儿肾脏各径线的数据： 1.本研究组胎儿肾脏各径线的左肾长径、横径和前后径分别从19周的1.870.22cm,1.14±0.10cm,1.100.07cm增长到38周的4.450.13cm，2.570.14cm,2.510.15cm，右肾各径线分别从19周的1.740.24cm，1.100.09cm，1.080.06cm增长到38周的4.440.16cm,2.560.13cm,2.500.13cm。 2.双侧肾脏各径线测量值之间无显著差异。 3.胎儿肾脏各径线与孕周呈正相关，左肾的长径、前后径和横径与孕周的决定系数分别为：0.93,0.723,0.75；右肾的长径、前后径和横径与孕周的决定系数分别为：0.819,0.69,0.60。二、三维VOCAL技术测量胎儿肾脏体积的数据： 1.本研究组胎儿左、右肾脏体积分别从19周的1.390.24cm3,1.330.24cm3增长到38周的14.611.55cm3，14.521.49cm3。 2.双侧肾脏体积测量值之间无显著差异。 3.双侧肾脏体积与孕周呈幂函数相关，左、右肾与肾脏的决定系数分别0.856,0.855。三、三维超声监测肾盂前后径≥10mm胎儿： 研究期间30例肾盂前后径宽度≥10mm的胎儿，每两周随访一次，，随访直至产后，10mm≤PAPD＜15mm的胎儿中，25例胎儿均于产后消失或减小,1例行先天性肾盂输尿管梗阻手术；PAPD≥15mm的胎儿中,RPT＜5mm且RI≥0.7者3例，先天性肾盂输尿管梗阻手术1例，引产2例。 本研究测量了15例28-38周胎儿PAPD≥10mm肾盂的体积，经随访观察至产后，其中有13例PAPD和肾盂体积于产后分别减小或消失，有1例引产，有1例于产后经核磁确认肾盂输尿管连接处梗阻。 结论 1、获得了不同孕周正常胎儿肾脏各径线及体积的参考值范围，为评价胎儿肾脏发育提供了重要的临床参考价值。 2、胎儿肾脏各径线与孕周呈线性相关，体积与孕周呈幂相关。 3、产前超声检查肾盂前后径（APD）≥15mm,肾实质厚度(RPT)＜5mm，肾动脉阻力指数（RI）≥0.7，肾盂体积/肾脏体积≥0.169的胎儿往往存在肾盂输尿管不同阶段的病理性梗阻，应高度重视。 4、应用三维超声API(Arbitrary Planar Imaging)、TUI及VOCAl技术有助于监测胎儿肾脏结构的发育，能够使肾脏与周围组织结构之间的相互关系更加清楚、直观的显现出来，尤其是通过三维超声TUI技术能够为肾盂扩张的宽度测量提供更可靠的切面，为产前筛查胎儿泌尿系统畸形提供了重要的临床依据。
[Abstract]:objective
The purpose of this study is to explore the dynamic monitoring of the length, diameter, diameter and volume of normal fetal kidney in different gestational weeks by three-dimensional ultrasound TUI (Tomographic Ultrasound Imaging) and VOCAL (Virtual Organ Computer aided Analysis), and to provide clues for the abnormal development of fetal kidneys. Correlation between volume and gestational age. Follow up the outcome of fetal pelvis anterior and posterior diameter exceeding normal range.
research method
From September 2012 to December 2013, 186 normal fetuses with the width of renal pelvis between 0-10mm were examined in the ultrasound room of the first clinical hospital affiliated to the first clinical hospital of Shanxi Medical University. The kidney was scanned by three-dimensional ultrasound, and the length, diameter and diameter of the fetal kidney were measured by three-dimensional ultrasound TUI technique. The three-dimensional ultrasonic VOCAL technique was used. The volume of the kidney was measured.
During the collection of cases, 30 cases of PAPD, Pelvic anteriorposterior diameter and 10mm were followed up. The diameter of the renal pelvis (PAPD), the thickness of the renal parenchyma (RPT, Renalparenchyma thickness), and the resistance index of renal portal renal artery (RI,) were observed by three-dimensional ultrasound TUI and VOCAL technique. Resistance index) and the volume of the renal pelvis.
Result
First, three dimensional TUI technology was used to measure the diameter of fetal kidney.
1. the left kidney length, the transverse diameter and the front and back diameter of the fetal kidneys in the study group were from 19 weeks 1.870.22cm, 1.14 + 0.10cm, and 1.100.07cm to 38 weeks of 4.450.13cm, 2.570.14cm, 2.510.15cm, and the right kidney from 19 weeks of 1.740.24cm, 1.100.09cm, 1.080.06cm to 38 weeks of 4.440.16cm, 2.560.13cm, 2.500.13cm..
2. there was no significant difference between the measured values of the diameters of bilateral kidneys.
3. the diameters of the kidneys were positively correlated with the gestational weeks. The length of the left kidney, the front and back diameter and the transverse diameter and the gestational weeks were respectively 0.93,0.723,0.75; the length of the right kidney, the front and back diameter and the transverse diameter and the gestational weeks were respectively 0.819,0.69,0.60. two, and the three-dimensional VOCAL technique was used to measure the fetal kidney volume.
1. The volume of left and right kidneys increased from 1.390.24 cm 3, 1.330.24 cm 3 at 19 weeks to 14.611.55 cm 3, 14.521.49 cm 3 at 38 weeks, respectively.
2. there was no significant difference in bilateral renal volume measurements.
3. the volume of bilateral kidney was related to the power function of gestational weeks. The determination coefficient of left, right kidney and kidney was 0.856,0.855. three, and the diameter of renal pelvis was more than 10mm fetus.
During the study, 30 fetuses with the width of the pelvis and the width of more than 10mm were followed up every two weeks and followed up until postpartum. Among the fetus of 10mm < PAPD < 15mm, 25 fetuses disappeared or decreased postpartum, and 1 cases of congenital ureteropelvic obstruction; RPT < 5mm and RI > 0.7 in 3 cases of congenital renal pelvis ureteral obstruction. 1 cases were performed and 2 cases were induced.
In this study, the volume of PAPD > 10mm pelvis in 15 cases of fetus was measured in 28-38 weeks. After follow-up, 13 cases of PAPD and renal pelvis decreased or disappeared after postpartum, 1 cases were induced, 1 cases were confirmed after postpartum by NMR to confirm the ureteropelvic junction obstruction.
conclusion
1. The reference ranges of various diameters and volumes of normal fetal kidneys at different gestational weeks were obtained, which provided important clinical reference value for evaluating fetal kidney development.
2, the diameters of fetal kidneys are linearly related to gestational age, and the volume is correlated with gestational weeks.
3, prenatal ultrasonography (APD) is more than 15mm, renal parenchyma thickness (RPT) < 5mm, renal artery resistance index (RI) more than 0.7, renal pelvis volume / renal volume more than 0.169 of fetuses often have pathological obstruction at different stages of renal pelvis and ureter, and should be highly valued.
4, the application of three-dimensional ultrasound API (Arbitrary Planar Imaging), TUI and VOCAl technology can help monitor the development of the fetal kidney structure, and can make the relationship between the kidney and the surrounding tissue structure more clear and intuitive, especially through the three-dimensional ultrasound TUI technology to provide more reliable section for the measurement of the width of the renal pelvis. It provides important clinical evidence for prenatal screening of fetal urinary system malformations.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.5;R445.1
本文编号：2155136
[Abstract]:objective
The purpose of this study is to explore the dynamic monitoring of the length, diameter, diameter and volume of normal fetal kidney in different gestational weeks by three-dimensional ultrasound TUI (Tomographic Ultrasound Imaging) and VOCAL (Virtual Organ Computer aided Analysis), and to provide clues for the abnormal development of fetal kidneys. Correlation between volume and gestational age. Follow up the outcome of fetal pelvis anterior and posterior diameter exceeding normal range.
research method
From September 2012 to December 2013, 186 normal fetuses with the width of renal pelvis between 0-10mm were examined in the ultrasound room of the first clinical hospital affiliated to the first clinical hospital of Shanxi Medical University. The kidney was scanned by three-dimensional ultrasound, and the length, diameter and diameter of the fetal kidney were measured by three-dimensional ultrasound TUI technique. The three-dimensional ultrasonic VOCAL technique was used. The volume of the kidney was measured.
During the collection of cases, 30 cases of PAPD, Pelvic anteriorposterior diameter and 10mm were followed up. The diameter of the renal pelvis (PAPD), the thickness of the renal parenchyma (RPT, Renalparenchyma thickness), and the resistance index of renal portal renal artery (RI,) were observed by three-dimensional ultrasound TUI and VOCAL technique. Resistance index) and the volume of the renal pelvis.
Result
First, three dimensional TUI technology was used to measure the diameter of fetal kidney.
1. the left kidney length, the transverse diameter and the front and back diameter of the fetal kidneys in the study group were from 19 weeks 1.870.22cm, 1.14 + 0.10cm, and 1.100.07cm to 38 weeks of 4.450.13cm, 2.570.14cm, 2.510.15cm, and the right kidney from 19 weeks of 1.740.24cm, 1.100.09cm, 1.080.06cm to 38 weeks of 4.440.16cm, 2.560.13cm, 2.500.13cm..
2. there was no significant difference between the measured values of the diameters of bilateral kidneys.
3. the diameters of the kidneys were positively correlated with the gestational weeks. The length of the left kidney, the front and back diameter and the transverse diameter and the gestational weeks were respectively 0.93,0.723,0.75; the length of the right kidney, the front and back diameter and the transverse diameter and the gestational weeks were respectively 0.819,0.69,0.60. two, and the three-dimensional VOCAL technique was used to measure the fetal kidney volume.
1. The volume of left and right kidneys increased from 1.390.24 cm 3, 1.330.24 cm 3 at 19 weeks to 14.611.55 cm 3, 14.521.49 cm 3 at 38 weeks, respectively.
2. there was no significant difference in bilateral renal volume measurements.
3. the volume of bilateral kidney was related to the power function of gestational weeks. The determination coefficient of left, right kidney and kidney was 0.856,0.855. three, and the diameter of renal pelvis was more than 10mm fetus.
During the study, 30 fetuses with the width of the pelvis and the width of more than 10mm were followed up every two weeks and followed up until postpartum. Among the fetus of 10mm < PAPD < 15mm, 25 fetuses disappeared or decreased postpartum, and 1 cases of congenital ureteropelvic obstruction; RPT < 5mm and RI > 0.7 in 3 cases of congenital renal pelvis ureteral obstruction. 1 cases were performed and 2 cases were induced.
In this study, the volume of PAPD > 10mm pelvis in 15 cases of fetus was measured in 28-38 weeks. After follow-up, 13 cases of PAPD and renal pelvis decreased or disappeared after postpartum, 1 cases were induced, 1 cases were confirmed after postpartum by NMR to confirm the ureteropelvic junction obstruction.
conclusion
1. The reference ranges of various diameters and volumes of normal fetal kidneys at different gestational weeks were obtained, which provided important clinical reference value for evaluating fetal kidney development.
2, the diameters of fetal kidneys are linearly related to gestational age, and the volume is correlated with gestational weeks.
3, prenatal ultrasonography (APD) is more than 15mm, renal parenchyma thickness (RPT) < 5mm, renal artery resistance index (RI) more than 0.7, renal pelvis volume / renal volume more than 0.169 of fetuses often have pathological obstruction at different stages of renal pelvis and ureter, and should be highly valued.
4, the application of three-dimensional ultrasound API (Arbitrary Planar Imaging), TUI and VOCAl technology can help monitor the development of the fetal kidney structure, and can make the relationship between the kidney and the surrounding tissue structure more clear and intuitive, especially through the three-dimensional ultrasound TUI technology to provide more reliable section for the measurement of the width of the renal pelvis. It provides important clinical evidence for prenatal screening of fetal urinary system malformations.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.5;R445.1
【参考文献】
相关期刊论文 前10条
1 邱海红;;彩超诊断胎儿肾盂积水90例[J];当代医学;2009年01期
2 林鹏飞;郝元斌;郭慧利;刘红林;芮荣;;猪分离卵泡体外培养过程中Fas/FasL对颗粒细胞凋亡的作用[J];动物学研究;2010年03期
3 黄丽卿;B型超声对正常胎儿肾脏的检测[J];临床超声医学杂志;2002年01期
4 董微,张建迎,韩玉环;胎儿肾脏与孕龄相关性研究[J];天津医药;2003年12期
5 程玉芳，张缙熙，张淑珍;B型超声诊断胎儿泌尿系畸形[J];中国超声医学杂志;1994年01期
6 胡淑君;胎儿小脑横径与孕龄的相关性探讨[J];中国超声医学杂志;1994年09期
7 王艳滨,张武;胎儿肾盂积水超声检查的作用[J];中华超声影像学杂志;2003年04期
8 高勇，王娟娟;超声测量孕妇肾体积预测胎儿宫内发育迟缓[J];中华超声影像学杂志;1995年05期
9 胡淑君;胎儿肾脏体积与孕龄的相关性及超声诊断胎儿肾脏发育异常的临床价值[J];中华妇产科杂志;2003年05期
10 秦平,马晓卿;胎儿肾盂积水产前诊断及产后转归的研究现状[J];中华医学杂志;2005年24期
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