| 孟婧,李天刚,苏晓荣,马菽阳,张海龙.产前超声鉴别诊断胎儿十二指肠闭锁[J].中国医学影像技术,2026,42(5):746~749 |
| 产前超声鉴别诊断胎儿十二指肠闭锁 |
| Prenatal ultrasound for differential diagnosis of fetal duodenal atresia |
| 投稿时间：2025-08-03 修订日期：2026-05-15 |
| DOI：10.13929/j.issn.1003-3289.2026.05.019 |
| 中文关键词: 胎儿 十二指肠梗阻 诊断,鉴别 超声检查,产前 |
| 英文关键词:fetus duodenal obstruction diagnosis, differential ultrasonography, prenatal |
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| 中文摘要: |
| 目的 观察产前超声鉴别诊断胎儿十二指肠闭锁的价值。方法 回顾性纳入53胎产前超声显示上腹部"双泡征"的先天性十二指肠梗阻(CDO)胎儿,根据病因将其分为十二指肠闭锁组(闭锁组,n=19)、十二指肠狭窄组(狭窄组,n=14)及环状胰腺组(n=20);对比观察各组超声表现,利用受试者工作特征(ROC)曲线分析各连续变量鉴别胎儿十二指肠闭锁与环状胰腺及十二指肠狭窄的最佳截断值。结果 闭锁组梗阻近端十二指肠横径和羊水指数均大于,而远端肠管充盈者占比小于狭窄组及环状胰腺组(校正P均＜0.05);狭窄组与环状胰腺组间上述参数差异均无统计学意义(校正P均＞0.05)。闭锁组及狭窄组十二指肠旁胰腺高回声带及"钳夹征"占比均低于环状胰腺组(校正P均＜0.05),而闭锁组与狭窄组之间差异均无统计学意义(校正P均＞0.05)。以梗阻近端十二指肠横径＞18.5 mm鉴别胎儿十二指肠闭锁与十二指肠狭窄及环状胰腺的敏感度为68.42%,特异度为88.24%;以羊水指数＞235 mm进行鉴别的敏感度为84.21%,特异度为61.76%。结论 产前超声可用于鉴别诊断胎儿十二指肠闭锁。 |
| 英文摘要: |
| Objective To observe the value of prenatal ultrasound for differential diagnosis of fetal duodenal atresia. Methods A total of 53 fetuses with congenital duodenal obstruction (CDO) and "double bubble" sign in the upper abdomen showed by prenatal ultrasound were retrospectively included and divided into duodenal atresia group (n=19), duodenal stenosis group (n=14) and annular pancreas group (n=20) according to the etiology. Prenatal ultrasound findings were observed and compared among groups. The receiver operating characteristic (ROC) curves were used to analyze the optimal cutoff value of continuous variables for differentiating fetal duodenal atresia, annular pancreas and duodenal stenosis. Results The transverse diameter of the duodenum proximal to the obstruction and the amniotic fluid index in duodenal atresia group were both greater, while the proportion of fetuses with distal bowel filling was smaller than those in duodenal stenosis group and annular pancreas group (all adjusted P＜0.05), while no significant difference of the above parameters was observed between duodenal stenosis group and annular pancreas group (all adjusted P＞0.05). The proportions of hyperechoic band of periduodenal pancreas and "clamp sign" in duodenal atresia group and duodenal stenosis group were both lower than in annular pancreas group (all adjusted P＜0.05), and no significant difference was found between the former 2 groups (both adjusted P＞0.05). When the transverse diameter of duodenum proximal to the obstruction＞18.5 mm was used to differentiate fetal duodenal atresia from duodenal stenosis and annular pancreas, its sensitivity was 68.42% and specificity was 88.24%. When an amniotic fluid index＞235 mm was used for differential diagnosis, the sensitivity was 84.21% and specificity was 61.76%. Conclusion Prenatal ultrasound could be used for differential diagnosis of fetal duodenal atresia. |
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