From the Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195 (M.M., S.F.Z., T.J.R., P.B., T.J.D.); Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (P.B.); Department of Laboratories, Seattle Children's Hospital, Seattle, Wash (J.R.S.); and Department of Radiology, Winthrop-University Hospital, Mineola, NY (D.S.K.).
Radiographics. 2014 Jan-Feb;34(1):179-96. doi: 10.1148/rg.341125127.
A complete fetal ultrasonographic (US) study includes assessment of the umbilical cord for possible abnormalities. Knowledge of the normal appearance of the umbilical cord is necessary for the radiologist to correctly diagnose pathologic conditions. Umbilical cord abnormalities can be related to cord coiling, length, and thickness; the placental insertion site; in utero distortion; vascular abnormalities; and primary tumors or masses. These conditions may be associated with other fetal anomalies and aneuploidies, and their discovery should prompt a thorough fetal US examination. Further workup and planning for a safe fetal delivery may include fetal echocardiography and karyotype analysis. Doppler US is a critical tool for assessment and diagnosis of vascular cord abnormalities. US also can be used for follow-up serial imaging evaluation of conditions that could result in fetal demise. Recent studies suggest that three- or four-dimensional Doppler US of the fetal umbilical cord and abdominal vasculature allows more accurate diagnosis of vascular abnormalities. Doppler US also is invaluable in assessment of fetal growth restriction since hemodynamic changes in the placenta or fetus would appear as a spectral pattern of increased resistance to forward flow in the fetal umbilical artery. Early detection of umbilical cord abnormalities and close follow-up can reduce the risk of morbidity and mortality and assist in decision making.
完整的胎儿超声（US）检查包括对脐带进行可能异常的评估。放射科医生需要了解脐带的正常外观，才能正确诊断病理情况。脐带异常可与脐带缠绕、长度和厚度、胎盘插入部位、宫内扭曲、血管异常、原发性肿瘤或肿块有关。这些情况可能与其他胎儿异常和非整倍体有关，发现这些情况应促使进行全面的胎儿 US 检查。进一步的检查和安全分娩计划可能包括胎儿超声心动图和染色体分析。多普勒 US 是评估和诊断血管脐带异常的重要工具。US 还可用于对可能导致胎儿死亡的情况进行连续的影像学随访评估。最近的研究表明，胎儿脐带和腹部血管的三维或四维多普勒 US 可以更准确地诊断血管异常。多普勒 US 在评估胎儿生长受限方面也非常有价值，因为胎盘或胎儿的血流动力学变化会表现为胎儿脐动脉正向血流阻力增加的频谱模式。早期发现脐带异常并密切随访可以降低发病率和死亡率的风险，并有助于决策。
