目的 探讨四维超声（four-dimensional ultrasound，4D）即实时三维，在胎儿手足畸形诊断中的应用价值。方法 对16 737例胎儿顺序进行二维超声（two-dimensional ultrasound，2D）和4D检查，重点观察胎儿手、足有无发育异常和其他合并畸形。将产前超声检查结果与引产后或产后结果相对照，比较2D与4D对胎儿手足畸形例数检出率、病变细节的检出率及病变部位图像质量。结果 经产后或引产后证实有61例120处胎儿手足畸形。2D及4D对胎儿手足畸形的病例检出率分别为77.05%（47/61）、93.44%（57/61），对胎儿手足畸形病变细节的检出率分别为71.67%（86/120）、89.17%（107/120），P值均＜0.05，差异均有统计学意义。65.57%病变部位的图像显示质量4D优于2D。结论 4D对胎儿手足畸形病例数、病变细节的检出率及病变部位图像质量明显优于2D，具有重要的临床使用价值。
Objective To discuss the value of four-dimensional （Real-time three-dimensional）ultrasound (four-dimensional ultrasound, 4D) in diagnosis of fetal hand-foot abnormalities. Method 16 737 fetuses were given 2D and 4D examinations mainly to detect the existence of fetal hand-foot anomalies and other associated malformations. Comparing the prenatal ultrasound results with post-natal evaluation or abortion findings, we contrasted the two methods inthe detection rate of fetal hand-foot abnormalities and in the detection rate of lesion details and in the image quality of the lesion sites. Results There were 61 fetuses with 120 lesion details confirmed with hand-foot abnormalities by post-natal evaluation or abortion. The detection rate with 2D for fetal hand-foot anomalies was 77.05% (47/61) and with 4D 93.44% (57/61); the detection rates of the lesion details were 71.67% (86/120) and 89.17% (107/120) separately, both P < 0.05, whose differences were statistically significant. 65.57% of the cases suggested the image quality of the lesion sites with 4D was better than that with 2D. Conclusions 4D is better than 2Din the detection rate of fetal hand-foot anomalies and in the detection rate of lesion details and in the image quality of lesion sites.
