发育医学电子杂志  2016, Vol. 4 Issue (1): 13-16 |
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结构畸形
专题笔谈
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| 先天性肛门直肠畸形的影像学检查 |
| 王刚 |
| 王刚（山东省立医院 小儿外科，济南 250021） |
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| Imaging examination of congenital anorectal malformation |
| WANG Gang |
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摘要 先天性肛门直肠畸形（congenital anorectal malformation，ARM）是一大类复杂畸形，涉及肛门直肠、神经、肌肉、骨骼，甚至泌尿、生殖道，新生儿发病率约为1/1 500~1/5 000。传统上采用Wingspread分类法，将ARM分为高位、中间位、低位［1］，一般认为，位置越高的畸形，术后排便功能越差。此外，患儿相关神经、肌肉、骨骼的发育情况以及合并畸形都与术后的排便功能有密切关系。现在的ARM治疗更加重视功能的重建，对影像学检查也提出了更高的要求，不仅要判断直肠盲端的位置，而且还要对骨骼、肌肉的发育情况作出评估。在术前通过影像学检查明确诊断，会提高ARM术后疗效。手术前后的影像学检查也有助于判断畸形对排便功能的影响。常用的ARM的影像学检查手段有超声检查、X线平片、X线造影、计算机断层扫描（CT）、磁共振成像（MRI）等。随着技术的进步，产前通过超声、MRI等检查手段可以检出部分ARM，从而为其及早治疗做好准备。
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收稿日期: 2015-12-28
出版日期: 2016-01-30
发布日期: 2018-01-31
期的出版日期: 2016-01-30
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