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J Zhejiang Univ (Med Sci)  2019, Vol. 48 Issue (4): 453-458    DOI: 10.3785/j.issn.1008-9292.2019.08.17
Assessment of fetal superior mesenteric artery and vein by three-dimensional power Doppler sonography
TANG Xianpeng1(),TAO Ruoling2,ZHANG Xinghao2,JIN Qiuzi2,HE Wei2,*()
1. Department of Ultrasonography, Changsha Central Hospital, Changsha 410004, China
2. Department of Ultrasonography, the Third Xiangya Hospital, Central South University, Changsha 410013, China
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Objective: To analyze the application of three-dimensional power Doppler sonography (3-DPDS) in evaluation of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in second-trimester fetus. Methods: Three-dimensional volume probe was used to collect the 3-DPDS blood flow images in 50 normal fetuses of 22+0-24+6 weeks and 50 fetuses of 30+0-32+6 weeks, respectively. The characteristics of three-dimensional ultrasound were analyzed. The clinical and imaging data of 4 fetuses of 26+3-32+1 weeks with midgut volvulus were analyzed retrospectively. Results: The display rates of SMA and SMV were 93%in normal group by 3-DPDS and those in volvulus group were 4/4 and 3/4, respectively. The SMV trunk was parallel to and on the right side of the SMA in the normal group, while 3 cases in volvulus group showed the characteristic relationship of SMV swirling around SMA. Conclusion: 3-DPDS can be used to observe the spatial relationship of SMA and SMV visually in fetus during the second trimester and is of value to diagnose and predict the outcome of midgut volvulus.

Key wordsMesenteric artery, superior/ diagnostic imaging      Intestinal volvulus/diagnostic imaging      Ultrasonography, prenatal      Fetus      Imaging, three-dimensional      Ultrasonography, doppler     
Received: 30 April 2019      Published: 30 October 2019
CLC:  R445.1  
Corresponding Authors: HE Wei     E-mail:;
Cite this article:

TANG Xianpeng,TAO Ruoling,ZHANG Xinghao,JIN Qiuzi,HE Wei. Assessment of fetal superior mesenteric artery and vein by three-dimensional power Doppler sonography. J Zhejiang Univ (Med Sci), 2019, 48(4): 453-458.

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目的: 分析三维能量多普勒超声(3-DPDS)技术评价孕中晚期胎儿肠系膜上动脉(SMA)和肠系膜上静脉(SMV)的可行性及临床应用价值。方法: 应用三维容积探头采集100名正常孕中晚期胎儿(22+0~24+6周50例、30+0~32+6周50例)的腹部3-DPDS血流图像,分析SMA和SMV的三维超声形态特征,同时回顾性比较分析4例中肠扭转胎儿(26+3~32+1周)的临床及影像数据。结果: 3-DPDS对健康组SMA和SMV的显像成功率均为93%(93/100),中肠扭转组中SMA和SMV的显像成功分别为4例和3例。健康组中SMV主干均位于SMA主干右侧与之平行,3例肠旋转不良致中肠扭转的胎儿可显示特征性的SMV缠绕SMA的空间关系。结论: 3-DPDS可以直观地显示中孕期胎儿SMA与SMV的空间位置关系,对中肠扭转的诊断和预后判断具有一定价值。

关键词: 肠系膜上动脉/影像诊断,  肠扭转/影像诊断,  超声检查, 产前,  胎儿,  成像, 三维,  超声检查, 多普勒 
Fig 1 The spatial position of normal fetal abdominal vessels by three-dimensonal power Doppler sonography
序号 孕龄(周) SMA显像 SMV显像 血管“缠绕征” 肠管“漩涡征” 妊娠结局 产后处理 产后诊断
1 26+3 阳性 阴性 阴性 阳性 引产 尸体解剖 肠旋转不良伴中肠扭转致部分肠坏死,SMV闭塞
2 30+6 阳性 阳性 阳性 阳性 剖宫产 手术 肠旋转不良伴中肠扭转
3 32+1 阳性 阳性 阳性 阳性 剖宫产 手术 肠旋转不良伴中肠扭转
4 28+2 阳性 阳性 阳性至阴性 阳性至阴性 顺产 随访观察 一过性中肠扭转(可疑肠系膜附着处狭窄)
Tab 1 The ultrasonographic signs and obstetrical management of fetuses in the volvulus group
Fig 2 The prenatal images of midgut volvulus
Fig 3 The winding sign of midgut volvulus of SMV with SMA showed by postpartum 2D ultrosonography and color Doppler flow imaging
Fig 4 The prenatal and postpartum images of the transient volvulus
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