Jiang Yi, Wang Weipeng, Pan Weihua, Wu Wenjie, Zhu Dan, Wang Jun
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.
Children (Basel). 2024 May 31;11(6):670. doi: 10.3390/children11060670.
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.
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.
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.
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.
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。
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。
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。
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。