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胎儿肠管扩张与先天性胃肠道畸形的相关性研究

Study of Correlation between Fetal Bowel Dilation and Congenital Gastrointestinal Malformation.

作者信息

Jiang Yi, Wang Weipeng, Pan Weihua, Wu Wenjie, Zhu Dan, Wang Jun

机构信息

Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Rd., Shanghai 200092, China.

Department of Pediatric Surgery, Hangzhou Children's Hospital, Hangzhou 310000, China.

出版信息

Children (Basel). 2024 May 31;11(6):670. doi: 10.3390/children11060670.

DOI:10.3390/children11060670
PMID:38929249
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11201953/
Abstract

BACKGROUND

Ultrasound serves as a valuable tool for the early detection of fetal bowel dilatation, yet the correlation between fetal bowel dilatation and gastrointestinal malformations remains to be further investigated. This study aims to explore the relationship by conducting a follow-up and analysis of fetuses with bowel dilation.

METHODS

A retrospective analysis was conducted on 113 fetuses with bowel dilatation at our center from July 2014 to December 2019. The location and degree of bowel dilatation were analyzed. ROC curves were constructed based on the diameter of the bowel and its ratio to fetal gestational age.

RESULTS

In total, 40 of 41 cases (97.6%) with upper gastrointestinal dilatation (double-bubble sign) and 46 of 72 cases (63.9%) with lower gastrointestinal dilatation were diagnosed with gastrointestinal malformations postnatally. The AUC of the dilatation diameter was 0.854 with a cutoff value of 18.05 mm in patients with lower gastrointestinal dilatation. The ratio of the diameter to gestational age (D/GA) showed a higher AUC of 0.906 with a cutoff value of 0.4931.

CONCLUSIONS

The presence of the double-bubble sign in fetuses indicates a close association with duodenal obstruction. The risk of gastrointestinal malformations increases when the bowel diameter exceeds 18.05 mm, particularly when the D/GA surpasses 0.4931.

摘要

背景

超声是早期检测胎儿肠道扩张的重要工具,但胎儿肠道扩张与胃肠道畸形之间的相关性仍有待进一步研究。本研究旨在通过对肠道扩张胎儿进行随访和分析来探讨两者之间的关系。

方法

对2014年7月至2019年12月在本中心诊断为肠道扩张的113例胎儿进行回顾性分析。分析肠道扩张的部位和程度。根据肠道直径及其与胎儿孕周的比值构建ROC曲线。

结果

41例上消化道扩张(双泡征)病例中有40例(97.6%),72例下消化道扩张病例中有46例(63.9%)在出生后被诊断为胃肠道畸形。下消化道扩张患者中,扩张直径的AUC为0.854,截断值为18.05 mm。直径与孕周比值(D/GA)的AUC更高,为0.906,截断值为0.4931。

结论

胎儿出现双泡征提示与十二指肠梗阻密切相关。当肠道直径超过18.05 mm时,尤其是当D/GA超过0.4931时,胃肠道畸形的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/d2a15c1c9866/children-11-00670-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/ba803b1e7c09/children-11-00670-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/39866c436bb8/children-11-00670-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/2c52cf543917/children-11-00670-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/9a9350f6d2bc/children-11-00670-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/d2a15c1c9866/children-11-00670-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/ba803b1e7c09/children-11-00670-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/39866c436bb8/children-11-00670-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/2c52cf543917/children-11-00670-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/9a9350f6d2bc/children-11-00670-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c3/11201953/d2a15c1c9866/children-11-00670-g005.jpg

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本文引用的文献

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Fetal Diagn Ther. 2020;47(2):98-103. doi: 10.1159/000500471. Epub 2019 Jun 5.
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Reference curves for the normal fetal small bowel and colon diameters; their usefulness in fetuses with suspected dilated bowel.正常胎儿小肠和结肠直径的参考曲线;它们在疑似肠扩张胎儿中的应用价值。
J Matern Fetal Neonatal Med. 2020 Feb;33(4):633-638. doi: 10.1080/14767058.2018.1498837. Epub 2019 Jan 6.
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Evaluation of pre- and postnatally diagnosed gastrointestinal tract obstructions.
产前和产后诊断的胃肠道梗阻的评估
J Matern Fetal Neonatal Med. 2019 Oct;32(19):3215-3220. doi: 10.1080/14767058.2018.1460350. Epub 2018 Apr 12.
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Growth of the colon and rectum throughout gestation: evaluation with fetal MRI.整个妊娠期结肠和直肠的生长:胎儿磁共振成像评估
Acta Radiol Open. 2018 Mar 4;7(3):2058460118761206. doi: 10.1177/2058460118761206. eCollection 2018 Mar.
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