Zieger B, Sokol B, Rohrschneider W K, Darge K, Tröger J
Abteilung Pädiatrische Radiologie, Universität Heidelberg, Germany.
Pediatr Radiol. 1998 Mar;28(3):156-61. doi: 10.1007/s002470050318.
The number of reports on the sonomorphology of the urachus or urachal remnants in neonates and the pattern of involution is limited.
To determine whether a sonographically visible urachus in the first months of life is a pathologic condition and whether postnatal involution can be demonstrated by ultrasound.
A total of 102 asymptomatic infants (premature and term newborns) were examined with a high-resolution 7.5-MHz linear transducer between 0 and 60 days of age. In 70 infants, a second examination followed 3-5 months later.
In all infants, the urachus could be identified on the first examination. Different morphological types were differentiated. There was no difference between premature and term newborns in the morphology of the urachus. Spontaneous involution of the urachus was observed in all infants receiving a second examination, and they most often showed a fusiform urachal remnant at the apex of the bladder.
Involution of the urachus is not complete at birth and can be followed up sonographically in the first months of life. This knowledge should prompt a new strategy in young infants with a discharging umbilicus or even an infected urachus. Instead of early surgery, a conservative approach under sonographic control seems reasonable, because there is a chance of spontaneous involution and any abnormal development can be detected by ultrasound.
关于新生儿脐尿管或脐尿管残余物的超声形态学以及退化模式的报告数量有限。
确定出生后最初几个月内超声可见的脐尿管是否为病理状况，以及产后退化能否通过超声显示。
使用7.5兆赫兹高分辨率线性探头对102例无症状婴儿（早产儿和足月儿）在0至60日龄时进行检查。70例婴儿在3至5个月后进行了第二次检查。
所有婴儿在首次检查时均可识别出脐尿管。区分出了不同的形态类型。早产儿和足月儿的脐尿管形态无差异。所有接受第二次检查的婴儿均观察到脐尿管的自发退化，且他们大多在膀胱顶部显示为梭形脐尿管残余物。
脐尿管在出生时并未完全退化，且在出生后的最初几个月内可通过超声进行随访。这一认识应促使针对有脐部渗液甚至脐尿管感染的婴儿采取新的策略。与早期手术不同，在超声监测下采取保守方法似乎是合理的，因为存在自发退化的可能性，且任何异常发育均可通过超声检测到。
