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Objective:To evaluate the placental micro-vascular circulation by microvascular flowing imaging (MVFI) method, and to explore the clinical value of microvascular index (MVI) for the diagnosis of fetal growth restriction (FGR).Methods:A total of 21 fetuses at 24-34 weeks of gestation at the Peking Union Medical College Hospital from October to November 2019 were enrolled in this study, including 7 fetal growth restriction (FGR) fetuses, and 14 normal fetuses as control group. The fetuses of the two groups were matched according to the gestational weeks at the ratio of 1∶2. Fetal biometry parameters were measured and the placenta was observed by two-dimensional ultrasound.Uterine artery pulse index (UtA-PI), middle cerebral artery pulse index (MCA-PI), and umbilical artery S/D ratio were evaluated by color and pulse-wave Doppler. The placenta mico-circulation was displayed by the MVFI method and MVI was measured.Results:The study included 14 normal fetuses and 7 FGR fetuses. Compared with the control group, more placenta in the FGR group manifested as thickened and heterogeneous with decreased MVI and increased UtA-PI. There was statistically significant difference in placental mean MVI between two groups ( P=0.044). Besides, a trend towards significant negative correlation was observed between MVI and placenta thickness, although this was not statistically significant ( rs=-0.35, P=0.065). MVI had a higher specificity (100%) in the prediction of FGR. Conclusions:MVFI can display the micro-circulation of the placenta, and provide a direct and quantitative assessment method for placental perfusion.
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Objective To explore the application value of ultrasound medical imaging workstation in quality control of ultrasound reports issued by resident doctors.Methods The pancreatic ultrasound reports of outpatients provided by resident doctors with 6 months and 12 months of training were derived from the ultrasound medical imaging workstation as 6-month group (G6M) and 12-month group (G12M),respectively.There were 1582 ultrasound reports in the G6M,including 420 for males and 962 for females,with 1318 for patients ＜ 65 years old and 264 for patients ≥ 65 years old.There were 2723 ultrasound reports in the G12M,including for 760 males and 1963 for females,with 2323 for patients ＜ 65 years old and 400 for patients ≥ 65 years old.Frequency of"unclear tail of the pancreas" in the report,standard image,and body markers were recorded.The chi-square test was used to compare patient gender,age,and the quality of resident reports between the two groups.Results The chi-square test showed that there was no significant difference in sex or age composition between the two groups (all P ＞ 0.05).The number of cases of"unclear tail of the pancreas" reported in the G6M and G12M was 554 (35.02％) and 734 (26.96％),respectively,and there was a statistical difference between the two groups (x2=31.029,P ＜ 0.001).In the reports with "unclear tail of the pancreas",the number of reports with "no map" was 8 (1.44％) and 14 (1.91％) in the G6M and G12M,respectively,and there was no significant difference between the two groups (P ＞ 0.05).As to "map without marker" and "map with marker",there were 337 (60.83％) vs 209 (37.73％) and 308 (41.96％) vs 412 (56.13％) in the G6M and G12M,respectively,and the chi-square test showed that there were significant differences between the two groups (x2=44.960 and 42.834,all P ＜ 0.001).Conclusion Ultrasound medical imaging workstation can be used for periodic spot check,evaluation,and feedback of resident reports,which has a positive role in promoting the quality control of ultrasound reports.
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Objective To determine the fetal facial angles at 11 －38 weeks of gestation by three‐dimensional ultrasound ( 3DUS) and analyze the correlation between facial angles and gestational age( GA ) . Methods From 2013 April to 2014 February ,439 singleton fetuses ranged 11－38 weeks of gestation were enrolled in this study . T he details of mid‐sagittal plane of facial profile was confirmed with 3DUS . Four facial angels were measured in this plane ,including frontomaxillary facial angle ( FM F ) ,frontonasal angle ( FNA ) ,mandibulomaxillary facial angle( M M F) and maxilla‐nasion‐mandible angle( M NM ) . T he intra‐and interobserver reliability were calculated in first 30 cases ,intra‐class correlation coefficient( ICC) greater than 0 .75 indicated good reliability . Pearson′s correlation coefficient ( r ) ,curve estimation and polynomial regression models were used to evaluate the correlation of the fetal facial angles with GA . Results ICC of the same observer were 0 .968 ,0 .962 ,0 .974 and 0 .988 ,respectively . ICC of different observer were 0 .948 , 0 .905 ,0 .874 and 0 .889 ,respectively . T he fetal facial angles of FM F ,FNA ,M M F and M NM showed correlations with GA ( r ＝ －0 .369 ,0 .447 ,－0 .470 ,0 .386 ; all P ＝0 .000) . Using GA as the independent variable and the facial angles as the dependent variables , the best fit regressing equation was cubic polynomial :FM F＝135 .300－6 .473×GA+0 .235×GA2 －0 .003×GA3 ( R2 ＝0 .240 , P ＝0 .000 ) ;FNA＝58 .920+7 .452×GA －0 .274×GA2 －0 .003×GA3 ( R2 ＝0 .297 , P ＝0 .000 ) ;M M F＝132 .329 －5 .337× GA+0 .191× GA2 －0 .002× GA3 ( R2 ＝ 0 .304 , P ＝ 0 .000) ;M NM ＝ －24 .592+ 4 .653× GA －0 .173× GA2 + 0 .002 × GA3 ( R2 ＝ 0 .413 , P ＝ 0 .000 ) . Conclusions The development of fetal facial angles are related to GA . T he growing patterns of fetal facial angles fit with a cubic polynomial function .
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Objective@#To explore the value of prenatal ultrasound in diagnosis of congenital dacryocystocele.@*Methods@#The ultrasonographic features of 16 fetuses with congenital dacryocystocele were retrospectively reviewed and the outcome of pregnancy were followed up.@*Results@#The median gestational week detected with prenatal ultrasound was 30.29 weeks, the mean diameter was (8.96±1.96)mm. Congenital dacryocystoceles were unilateral in 12 fetuses and bilateral in 4 fetuses, 10 were female and 6 were male. The typical ultrasonic feature was anechoic cystic mass with clear boundary in relation to the medial and inferior aspects of the fetal orbit. The dacryocystocele resolved spontaneously prenatally in 5 fetuses, resolved spontaneously after delivery in 10 fetuses. One fetus died in caesarean section due to complete placenta previa.@*Conclusions@#Congenital dacryocystitis has its characteristic ultrasonographic features, and most cases can disappear naturally in prenatal or early newborns.
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Objective To evaluate the fetal profile (FP) line with two-dimensional and three dimensional ultrasound, to explore the changes of fetal facial profile with gestational age,and to analyze the manifestation of FP line for abnormal chromosomal fetuses. Methods FP line, which was defined as the line that passes through the anterior border of mandible and the nasion, was test on the facial mid-sagittal plane. Firstly, from April 2013 to January 2014, FP line was analyzed in 439 normal fetuses of Peking Union Medical College Hospital at 11-38 weeks of gestation. According to the relationship between FP line and fetal frontal bone,it was divided into three types: the FP line passed anteriorly, across or posteriorly to the frontal bone, respectively. When the FP line passed posteriorly to the frontal bone, the distance (F distance) between the FP line with the frontal bone was measured. Secondly, 26 pathological fetuses (21 trisomy 21 fetuses with 13-33 weeks' gestation and 5 trisomy 18 fetuses with 21-31 weeks' gestation) were analyzed respectively. Results No cases with a FP line passed anteriorly to the frontal bone were found in all of normal fetuses. Most commonly seen was that FP line passed across to the frontal bone (92.26%). The FP line passed posteriorly to the frontal bone in up to 7.74%, and the mean F distance was 0.24 cm (range, 0.10-0.51 cm). In 21 fetuses of trisomy 21, 14 cases showed the FP line passed across to frontal bone, and 4 cases showed the FP line passed posteriorly frontal bone with the F distance from 0.23 cm to 0.55 cm. Three cases with sloping forehead with FP line passed anteriroly to frontal bone. As to 5 cases of trisomy 18, 2 cases showed FP line passed across to frontal bone, and 3 cases with micrognathia had FP line passed anteriroly to frontal bone. Conclusions No cases with a FP line passed anteriorly to the frontal bone were found in normal fetuses. The FP line, as a reference line for forehead and mandible abnormality, may be a useful tool to detect second trimester profile abnormalities such as sloping forehead and retrognathia.
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Objective To investigate the diagnostic value of prenatal ultrasonography in the fetal intracranial hemorrhage.MethodsIn a retrospective analysis,the ultrasonographic findings of five fetuses with intracranial hemorrhage diagnosed in our hospital were reviewed and compared with other imagemodalities.ResultsIn the five fetuses with intracranial hemorrhage,the ultrasonographic features mainly includeddilateduni-orbilateralventriclesandintraventricularechogenicfociorperiventricular echodensities.The diagnosis of all cases were confirmed by prenatal magnetic resonance.Four of these cases chose termination of pregnancy,and the other fetus had a normal neurological follow-up after birth.Conclusions Fetal intracranial hemorrhage can be diagnosed accurately by prenatal ultrasonography,especially in the second and third trimester.It is rarely associated with other anomalies.Prenatal sonographic examination may detect the lesion and help to evaluate the prognosis.