Nyberg D A, Hegge F N, Kramer D, Mahony B S, Kropp R J
Department of Ultrasound, Swedish Hospital Medical Center, Seattle, Washington.
J Ultrasound Med. 1993 Jun;12(6):331-5. doi: 10.7863/jum.1993.12.6.331.
Sonograms from 49 fetuses with cleft lip, with or without cleft palate, were reviewed. Among 37 fetuses with adequate pathologic or clinical correlation, 10 (27%) demonstrated premaxillary protrusion, seen as a paranasal echogenic mass. Nine of ten fetuses with a paranasal echogenic mass proved to have bilateral cleft lip and cleft palate. Conversely, only two of 27 fetuses who did not show a paranasal echogenic mass proved to have bilateral cleft lip and cleft palate, and neither of these fetuses showed premaxillary protrusion at birth. Sonographic evaluation of the cleft alone erroneously misclassified eight fetuses with bilateral cleft lip and cleft palate as having unilateral clefts. Premaxillary protrusion is an important clue to the presence of cleft lip and cleft palate and may be more conspicuous than the cleft itself. Furthermore, the presence of a paranasal echogenic mass favors the presence of bilateral cleft lip and cleft palate, even when sonographic evaluation of the cleft itself suggests a unilateral cleft. This information should be useful in the detection and management of fetuses with suspected facial clefts.
对49例唇裂（伴或不伴腭裂）胎儿的超声图像进行了回顾性分析。在37例有充分病理或临床相关性的胎儿中，10例（27%）表现为上颌前突，表现为鼻旁强回声团块。10例有鼻旁强回声团块的胎儿中有9例被证实为双侧唇腭裂。相反，在27例未显示鼻旁强回声团块的胎儿中，只有2例被证实为双侧唇腭裂，且这2例胎儿出生时均未表现出上颌前突。仅对腭裂进行超声评估会错误地将8例双侧唇腭裂胎儿误诊为单侧腭裂。上颌前突是唇腭裂存在的重要线索，可能比腭裂本身更明显。此外，即使对腭裂本身的超声评估提示为单侧腭裂，鼻旁强回声团块的存在也提示双侧唇腭裂的可能性较大。这些信息对于疑似面部腭裂胎儿的检测和管理应是有用的。
