Emanuel P G, Garcia G I, Angtuaco T L
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock 72205-7199, USA.
Radiographics. 1995 May;15(3):517-30. doi: 10.1148/radiographics.15.3.7624560.
The size and position of an anterior abdominal wall defect, its contents, and its association with other anomalies are features that can be diagnosed in utero with ultrasound and that allow a differential diagnosis to be made. The correct prenatal diagnosis is extremely important for patient management. The key feature for sonographically distinguishing these conditions is the position of the defect in relation to the umbilical cord insertion. Omphaloceles and pentalogy of Cantrell usually involve a midline defect at the umbilical cord insertion. Gastroschisis most frequently consists of a small, right-sided paraumbilical defect. Eccentric, large lateral defects are typically present in limb-body wall complex or amniotic band syndrome. Bladder and cloacal exstrophy involve the infraumbilical region. In addition, the size of the defect, the organs eviscerated, the presence of membranes or bands, and any associated abnormalities help determine the correct diagnosis. Increased knowledge of these uncommon fetal conditions should result in better detection, more accurate diagnosis, and improved management of anterior abdominal wall defects.
前腹壁缺损的大小、位置、内容物及其与其他异常的关联，是可通过超声在子宫内诊断的特征，有助于进行鉴别诊断。正确的产前诊断对患者管理极为重要。超声鉴别这些情况的关键特征是缺损相对于脐带插入点的位置。脐膨出和坎特雷尔五联症通常涉及脐带插入处的中线缺损。腹裂最常见的是小的、右侧脐旁缺损。肢体-体壁复合体或羊膜带综合征通常存在偏心的、大的外侧缺损。膀胱外翻和泄殖腔外翻累及脐下区域。此外，缺损的大小、脱出的器官、有无膜或带以及任何相关异常有助于确定正确诊断。对这些不常见胎儿疾病的了解增加，应能更好地检测、更准确地诊断并改善前腹壁缺损的管理。
