常规超声联合三维超声诊断胎儿阴茎阴囊转位的临床价值 [中文引用][英文引用]

目的 探讨胎儿阴茎阴囊转位的声像图特征及超声在诊断此畸形中的应用价值。方法 分析10例产前超声系统检查诊断为阴茎阴囊转位胎儿的二维及三维超声声像图，并与引产后生殖器外观形态进行对比，找出胎儿阴茎阴囊转位的声像图特征及可能导致发育异常的因素。结果 10例胎儿足月生产6例, 家属选择引产4例。生后经小儿外科医师会诊检查均证实为阴茎阴囊转位，10例均为部分性阴茎阴囊转位，并同时合并尿道下裂，其中3例合并肛门闭锁，足月生产6例中2例合并隐睾。6例母体早孕期间行黄体酮或地屈孕酮保胎治疗。胎儿阴茎阴囊转位有典型的声像图特征：胎儿外生殖器形态失常，阴囊分离,阴茎短小并下弯，阴茎位于分离阴囊中间或下方。可通过实时超声观察胎儿喷尿尿流走向，确定尿道口的大体位置，估测尿道下裂类型。结论 胎儿阴茎阴囊转位具有典型的声像图特征，产前超声对阴茎阴囊转位的诊断和鉴别诊断提供了可靠的诊断依据，该畸形与孕期应用保胎药物有一定联系。

Objective To observe the ultrasonic characteristics and their value of antenatal diagnosis of fetal penoscrotal transposition. Method Ultrasonograms of 10 fetuses diagnosed of penoscrotal transposition with conventional and three-dimensional prenatal ultrasound were analyzed,and the characteristics were discussed. The prenatal characteristics were summarized by ultrasound and compared with those of antopsy. To analyze the ultrasonic characteristics and discuss the factors that may lead to developmental abnormalities. Results Of 10 tetuses,6cases of full-term were born，4 cases were induced labor.10 were proved to have penoscrotal transposition after physical examination，all of them were incomplete and accompanied with hypospadias.3 were accompanied anal atresia.2 were accompanied cryptorchidism in which were born of full-term.6 matrixes once accepted tocolytic therapy with progesterone during early pregnancy. T he ultrasonographic features of fetal penoscrotal transposition can display abnormal anatomy of fetal genitalia, such as small penises with chordee, or penises that are localized between or below separated scrotum. Real-time ultrasound can be applied to observe the flow of fetal urination, and thus identify the probable site of urethral meatus and infer the type of hypospdias. Conclusions Fetal penoscrotal transposition has some ultrasonic characteristics Therefore, prenatal ultrasound provides the reliable basis for diagnosis and differential diagnosis of fetal penoscrotal transposition, that is, to some extent, associated with tocolytic drug use during pregnancy.