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【读片】thefetus病例（181）：闪烁伪像 [病例帖]

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这个帖子发布于14年零106天前，其中的信息可能已发生改变或有所发展。

上一病例：【读片】thefetus病例（180）：面横裂畸形（Tessier 7型面裂）

These are some images of 31-year-old-primigravida with an unimportant familiar history. This was the first trimester scan.

一31岁初产妇的一些图像，没有异常家族史，下面是早期妊娠的检查情况。

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2006-11-17 15:10 浏览 : 1610 回复 : 12

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xihuansushi 编辑于 2006-12-01 20:21

• 且亭读医笔记：进展性脑卒中

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原始图片是不是有些模糊呀？
适当的处理一下，看看这样是否好些呢？

bruceliu1979 wrote:
看了好多边，提点想法。
1,NT厚度似乎正常，NB未见缺失，是否在提示该胎儿无染色体异常。
2，如果为膈疝，心脏被挤压如此严重，值得怀疑。
3，图A如果是胸部横断面，似乎存在心脏结构，但无血流信号，遗憾的是图片未显示胸壁处异常血流与主动脉与腔静脉的关系。
4，什么畸形可以绕过心脏而直接与主动脉和腔静脉建立联系。
5，图片未显示脐动静脉与胎儿的联系，使诊断造成困难。
故考虑该胎儿有复杂畸形，考虑可能与脐动脉和心脏发育有关，好多疑问无法解释，期待结果。

1、NT感觉还是有些厚，NB也感觉不是很正常，应该提示胎儿存在染色体异常。
2、感觉没有正常的心脏存在，看两幅频谱就能发现根本不正常。
3、图中所标示的应该是腔静脉和主动脉吧。
4、下图中的“？？”可见杂乱的血流信号和杂乱的频谱，应该重点的分析，可惜我看不出来是什么异常。

2006-11-20 10:45

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xihuansushi 编辑于 2006-11-20 10:57

• 节后焦虑、不想上班？一招帮你找回工作状态！

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我们都上当了呀。结果是：
These are some images of 31-year-old-primigravida with an unimportant familiar history. This was the first trimester scan. The findings represented scintillation artifact (twinkling artifact).
这些表现是闪烁伪像。

2006-12-01 18:01

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• 11岁女孩患水痘医院误开死亡证明

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Twinkling artifact

Synonyms

Scintillation artifact, twinkle artifact.

Definition

Twinkling artifact is a color phenomenon visible behind a strongly reflecting interface such as urinary tract stones, parenchymal calcification or bones during color Doppler examination. It manifest itself as a color signal but without real flow behind the structures. It imitates turbulent flow.

This artifact has been described behind calcifications in various tissues.

Etiology

Twinkle artifact occurs behind highly reflective objects, particularly urinary tract’s stones [1, 2]. Earlier authors believed that this artifact was dependent on surface roughness [4]. Some newer articles describe this artifact as a phenomenon dependent on ultrasound machine settings (color-write priority, gray-scale gain, and pulse repetition frequency), motion of the object scanned with respect to the transducer, and equipment used [2].

Presence of this artifact is sometimes beneficial, such as in cases of detection of urinary trakt"s stones with indistinct echogenicity and inconsiderable posterior acoustic shadowing. In some studies the twinkling artifact was present in 83% of urinary stones [2]. That is why it can be used as one of the diagnostic criteria for urinary calculi.
On the other hand, twinkling artifact can be a source of confusion, for example, in prenatal fetal scans. It can imitate aberrant vessels or flows behind echogenic structures, or give the impression of cardiac activity in fetal demise. (See the Pitfalls & Artifacts lecture for some video clips on the subject).

Because this artifact is dependent on ultrasound machine settings it is possible to distinguish it from real vessels by changing some parameters. For instance, when the focal zone is above the source of the artifact (such as a urinary stone) the artifact disappears, but when the focal zone is under the hyperechoic area it occurs [2]. This could be an easy distinguishing maneuver in assessment of this phenomenon.

2006-12-01 18:02

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• 关于调剂你了解多少？

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