Zhang Bo, Zhang Wen, Hu Yong, Pang Houqing, Yang Haibo, Luo Hong
Department of Ultrasound, West China Second Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu, China.
Quant Imaging Med Surg. 2024 Sep 1;14(9):6386-6396. doi: 10.21037/qims-24-445. Epub 2024 Aug 7.
Congenital duodenal obstruction (CDO) is commonly detected antenatally through the presence of the "double bubble" sign on prenatal ultrasound, denoting dilatation of the stomach and duodenum. Subsequent postnatal ultrasonography plays a pivotal role in determining the causes of obstruction, thereby informing surgical strategies and neonatal management. The aim of this study was to investigate the diagnostic accuracy of postnatal ultrasonography in comparison to that of prenatal ultrasound and surgical findings in a cohort of 43 patients with fetal double bubble sign.
A total of 43 patients, comprising 24 males and 19 females, who exhibited double bubble sign on prenatal ultrasound were subjected to postnatal ultrasound assessment at a tertiary care facility during the 2018-2023 period. The accuracy of both pre-and postnatal ultrasonography in the identification and diagnosis of CDO, as well as its underlying causes, was compared to that of the established gold standard of surgical findings.
The accuracy rates for prenatal and postnatal ultrasonic diagnosis of CDO were 97.7% (42/43) and 100% (42/42), respectively. In terms of etiological diagnosis, prenatal and postnatal ultrasound correctly identified the causes of obstruction in 45.2% (19/42) and 81.0% (34/42) of cases, respectively, as confirmed by surgical intervention.
The presence of the prenatal double bubble sign serves as a highly reliable indicator for CDO. Additionally, postnatal ultrasonography proved to be a valuable tool in refining the diagnosis and determining the underlying causes of obstruction in neonates.
先天性十二指肠梗阻（CDO）通常在产前通过产前超声检查发现的“双泡征”来检测，该征表示胃和十二指肠扩张。随后的产后超声检查在确定梗阻原因方面起着关键作用，从而为手术策略和新生儿管理提供依据。本研究的目的是在一组43例有胎儿双泡征的患者中，比较产后超声检查与产前超声检查及手术结果的诊断准确性。
2018年至2023年期间，共有43例患者（包括24例男性和19例女性）在产前超声检查中出现双泡征，在三级医疗机构接受了产后超声评估。将产前和产后超声检查在CDO及其潜在原因的识别和诊断方面的准确性与既定的手术结果金标准进行比较。
产前和产后超声诊断CDO的准确率分别为97.7%（42/43）和100%（42/42）。在病因诊断方面，经手术干预证实，产前和产后超声分别在45.2%（19/42）和81.0%（34/42）的病例中正确识别了梗阻原因。
产前双泡征的出现是CDO的高度可靠指标。此外，产后超声检查被证明是完善诊断和确定新生儿梗阻潜在原因的有价值工具。
