背景:面部裂痕是胎儿面部最常见的先天性畸形之一,超声检查主要负责其诊断。很难看到胎儿的腭,所以目前没有统一的胎腭筛查标准,并且相关的产前超声筛查指南中不包括腭裂的诊断。由于缺乏有效的筛查方法,许多腭裂的产前诊断被错过。因此,必须提高胎儿腭的显示率,提高腭裂的检出率和诊断准确性。我们的目标是引入一种基于“口腔裂隙连续扇形扫描”的胎儿腭筛查软件,通过我们的随访结果和三维超声验证了该方法的可行性和临床实用性。
方法:基于“通过口腔裂隙的顺序扇形扫描”和三维超声设计和编程软件。将胎儿面部三维超声容积数据导入软件。然后,正中矢状面作为参考界面,选择下颌牙槽骨的前上缘作为支点,间隔角度,并设置扇形扫描的层数,之后进行自动扫描。因此,扇形扫描下颌牙槽骨的顺序平面,咽部,软腭,硬腭,依次获得上颌牙槽骨,以显示和评估腭。此外,通过实际临床病例评估软件在胎儿腭显示和筛查中的可行性和准确性。
结果:显示了正常胎儿腭和腭裂缺损部位的完整视图,将10个正常胎腭和10个腭裂的三维体数据导入软件后,形成相对清晰的序贯断层图像和连续动态视频。
结论:该软件可以更直接地显示胎儿腭,这可能是一种新的胎儿腭筛查和腭裂诊断方法。
BACKGROUND: Orofacial clefts are one of the most common congenital malformations of the fetal face and ultrasound is mainly responsible for its diagnosis. It is difficult to view the fetal palate, so there is currently no unified standard for fetal palate screening, and the diagnosis of cleft palate is not included in the relevant prenatal ultrasound screening guidelines. Many prenatal diagnoses for cleft palate are missed due to the lack of effective screening methods. Therefore, it is imperative to increase the display rate of the fetal palate, which would improve the detection rate and diagnostic accuracy for cleft palate. We aim to introduce a fetal palate screening
software based on the \"sequential sector scan though the oral fissure\", an effective method for fetal palate screening which was verified by our follow up results and three-dimensional ultrasound and to evaluate its feasibility and clinical practicability.
METHODS: A
software was designed and programmed based on \"sequential sector scan through the oral fissure\" and three-dimensional ultrasound. The three-dimensional ultrasound volume data of the fetal face were imported into the
software. Then, the median sagittal plane was taken as the reference interface, the anterior upper margin of the mandibular alveolar bone was selected as the fulcrum, the interval angles, and the number of layers of the sector scan were set, after which the automatic scan was performed. Thus, the sector scan sequential planes of the mandibular alveolar bone, pharynx, soft palate, hard palate, and maxillary alveolar bone were obtained in sequence to display and evaluate the palate. In addition, the feasibility and accuracy of the
software in fetal palate displaying and screening was evaluated by actual clinical cases.
RESULTS: Full views of the normal fetal palates and the defective parts of the cleft palates were displayed, and relatively clear sequential tomographic images and continuous dynamic videos were formed after the three-dimensional volume data of 10 normal fetal palates and 10 cleft palates were imported into the software.
CONCLUSIONS: The
software can display fetal palates more directly which might allow for a new method of fetal palate screening and cleft palate diagnosis.