1、妇儿超声检查手册(超声正常值)来源： 点击：221发布时间：2014-10-27 14:54:21核心提示：美中宜和妇儿医院超声检查手册一、正常早孕期1 孕龄计算公式 孕天数=胎囊平均内径（长+宽+厚） 3（mm） +303天2 孕龄计算公美中宜和妇儿医院超声检查手册一、正常早孕期1. 孕龄计算公式 孕天数=胎囊平均内径（长+宽+厚）/3（mm） +303天2. 孕龄计算公式 孕天数=孕囊最大经线+3天此两个测量公式适用于孕7周之内，但有一定误差。3. 孕龄（天）=CRL+424. 孕龄（周）=CRL+6.5此两公式适用于孕7-12周。测量时不包括卵黄囊及肢体，取胚胎躯体最长最直的正中矢面图，
2、测量最长经线，最好取三次测量平均值。5. 胎囊每日生长速度：1-1.5mm/d6. 正常早中期超声孕周可见孕周胚胎大小mm正常超声所见5可见小胎囊及卵黄囊，胎囊约占宫腔1/463.2胎囊清晰可见，可见卵黄囊、胎芽及胎心79.3清楚可见胎芽、胎心，胎囊约占宫腔1/3815.7可区分胎头、胎体，胎囊约占宫腔1/2，可见蠕动922.6胎囊几乎占满宫腔，胚胎轮廓清晰，胎头、脑泡及肢芽可见1030.7胚胎肢芽清晰可见，活跃于羊水中，胎盘开始形成1140.6胎囊完全消失，胎盘清晰可见，四肢骨，指趾清晰可见1252.8胎儿颅骨光环清晰，脊柱及四腔心可见 简单记忆：5囊6芽7心8动9胎盘7. 胎儿停止发育胎囊
3、平均内径2.5cm，未见胎芽或胎芽长0.6cm，未见胎心搏动。注意：观察胎心搏动要在2分钟以上8. 胎儿妊娠结局不良（1）孕囊平均内径-CRL5mm（2）孕早期胎心率80bpm9. 胎儿NT增厚测量范围：头臀长44mm-85mm 相当于孕11周2天-14周3天 正常NT3.0mm 50%的21三体，25%的18三体及10%的turner综合症NT或NF增厚 对于高龄孕妇（年龄大于35岁），唐氏高危者，孕11-12周，NT2.5mm，考虑增宽。二、产前筛查（孕11-14周）要求 测量胎儿头臀长并估计孕周 胎儿矢状面测量NT厚度和鼻骨的显示 胎儿侧脑室显示显示胎儿心脏、胃泡显示胎儿四肢 此期可筛查
4、出的畸形：无脑儿、全前脑、脑膨出、四肢异常、NT增厚 如果检查胎儿NT增厚，注意胎儿鼻骨有无缺失或过短，有无三尖瓣反流。NT增厚应建议做羊穿检查。三、孕中期胎儿筛查要求1、 头部（1）颅骨大小：双顶径平面测量形态：正常为椭圆形，无局部突出或缺失，无柠檬头或草莓头完整性：无骨质缺损骨密度：回声过弱或过强应考虑颅骨质矿化问题，如成骨不全、低磷酸酯酶症等。（2）脑结构侧脑室水平横断面：观察脑中线、脉络丛、侧脑室、透明隔丘脑水平横断面：丘脑、透明隔、经小脑横切面：小脑横径、小脑蚓部、大脑延髓池颅底横切面：大脑脚 Wellis环颅脑正中矢状切面：丘脑、胼胝体2、 脊柱 显示整个脊柱颈椎、胸椎、腰椎、尾椎
5、（矢状、冠状切面）膀胱水平横切面显示三个骨化中心的排列3、 面部上唇的完整性、双眼眶、面部轮廓、口唇、鼻孔矢状面显示鼻骨4、 颈部观察颈部有无肿物，如颈部水囊瘤或畸胎瘤5、 胸部胸廓形态规则，肋骨自然弯曲，无短肋；双肺回声均匀，无纵膈或肿物；膈肌呈线状回声，分隔胸腹部脏器。6、 心脏正常四腔心，对称，左右室流出道，无膈疝证据，心率7、 腹部胃泡位置正常，肠管无扩张，双肾、膀胱均显示；脐带腹壁入口处可见8、 肢体显示双上肢、双下肢、双手、双足及其连接关系9、 其他胎盘：位置，有无肿物及副胎盘 宫颈内口长度、形态脐带：三根血管外生殖器、宫颈、子宫形态及附件(斜体部分为产前诊断要求)四、胎儿生物测量
6、正常值1、胎儿头臀长与孕周孕周CRL孕周CRL孕周CRL孕周CRL孕周CRL10周0天3.0511周0天4.0512周0天5.2513周0天6.6514周0天7.9510周1天3.1511周1天4.1512周1天5.4513周1天6.7514周1天8.0510周2天3.3511周2天4.4512周2天5.6513周2天7.0514周2天8.3510周3天3.4511周3天4.5512周3天5.8513周3天7.1514周3天8.4510周4天3.5511周4天4.6512周4天5.9513周4天7.3514周4天8.5510周5天3.7511周5天4.8512周5天6.2513周5天7.551
7、4周5天8.7510周6天3.8511周6天5.0512周6天6.3513周6天7.6514周6天8.852、正常胎儿双顶径、头围、腹围、股骨长（medison）孕周双顶径头围腹围股骨长131.90-2.347.2-8.86.3-7.41.00-1.33142.35-2.748.9-10.407.5-8.61.34-1.66152.78-3.1710.45-11.958.7-9.81.67-1.99163.18-3.5511.96-13.49.9-11.02.00-2.30173.56-3.9113.45-14.7911.1-12.22.31-2.59183.92-4.2614.8-16.19
8、12.3-13.42.61-2.90194.27-4.6016.2-17.3913.5-14.62.91-3.19204.61-4.9317.40-18.5914.7-15.73.20-3.46214.95-5.2418.60-19.7515.8-16.93.47-3.74225.25-5.5419.76-20.8417.0-18.03.75-4.00235.55-5.8420.85-21.8918.1-19.14.01-4.26245.85-6.1421.90-22.8919.2-20.34.27-4.49256.15-6.4122.90-23.8920.4-21.44.50-4.74266
9、.42-6.6823.90-24.8021.5-22.54.75-4.99276.69-6.9424.81-25.6922.6-23.65.00-5.25286.95-7.2025.70-26.5923.7-24.75.26-5.47297.21-7.4626.60-27.4024.8-25.75.48-5.69307.47-7.6927.40-28.1925.8-26.85.70-5.94317.70-7.9528.20-28.9026.9-27.85.95-6.15327.96-8.1929.00-29.7027.9-28.96.16-6.36-338.20-8.4229.80-30.49
10、29.0-30.06.37-6.59348.43-8.6530.60-31.2030.1-30.96.60-6.79358.66-8.8831.30-31.8031.0-32.06.80-7.00368.89-9.1031.90-32.5932.1-33.07.01-7.20379.11-9.3232.60-33.2033.1-34.07.21-7.40389.33-9.5333.30-33.8934.1-35.07.41-7.60399.54-9.7533.90-34.5035.1-36.07.61-7.80409.76-9.9634.60-35.1036.1-36.97.81-8.0041
11、9.97-10.1635.20-35.7037.0-37.98.01-8.24210.17-38.0（1）BPD孕31周前，每周增长约3mm，孕31-36周增长1.5mm/周，孕36周后，增长1mm/周；在孕12-28周测值最接近孕周。受胎方位、不同头形或胎头入盆等因素影响，孕晚期BPD测值会出现较大偏差。（2）孕30周前FL增长2.7mm/周，31-36周增长2mm/周, 36周后增长1mm/周。3、超声参数解读：（1）头径指数CI=头短轴径BPD /头长轴径OFD 正常范围70%-86% 头径指数在正常范围时，BPD适合评估体重。头径指数小于70%或大于86%时，应该用头围来评估体重。（2
12、）FL/AC正常 20%24%FL/AC 24% 可能有IUGR，应放弃AC测量（3）FL/BPD正常 71%87%如FL/BPD 87 %，则放弃BPD测量（4）HC/AC正常 0.961.17 正常孕35周前，腹围小于头围；孕35周左右，比值基本相等；孕35周后，腹围大于头围。（5）FL/HC小于3SD 提示骨发育不良。4、胎儿小脑横径正常值（参考美国妇产科学1987年）孕周10th50th90th孕周10th50th90th孕周10th50th90th161416172422252832333842171617182523282933324044181718192625293234334
13、0441918192227263032353140.5472018202228273134363643552119222429293438373745552221232430313540384048.555232224263132384339525255孕24周前，小脑横径约等于孕周，孕20-38周，平均增长约1-2mm/周；孕24周后，小脑横径值明显大于孕周，妊娠38周后，平均增长约0.7mm/周。5、胎儿小脑蚓部正常值孕周（周）前后径（mm）顶尾径（mm）周长（mm）面积（cm2）21-2210. 61.411.11.143.83.30.90.223-2412.91.112.31.447.
14、55.51.20.225-2613.52.113.60.950.94.41.40.227-2816.32.716.01.658.96.82.00.529-3017.52.217.72.164.76.52.30.431-3219.01.919.21.170.76.92.80.433-3419.21.919.81.072.78.33.00.835-3621.41.521.22.377.65.13.40.337-3822.13.823.04.680.79.93.91.439-4025.72.325.02.686.77.04.90.76、诊断小头畸形头围参考值（ cm 李胜利）孕周正常-2SD-3SD
15、-4SD孕周正常-2SD-3SD-4SD201814.513.111.63128.626.024.523.02119.215.714.312.83229.426.825.323.92220.316.915.414.03330.227.626.124.62321.418.016.615.13430.928.326.825.32422.419.117.716.23531.528.927.526.02523.420.218.817.33632.429.528.126.62624.421.319.818.33732.930.128.627.22725.322.320.819.43833.930.629
16、.127.62826.223.321.820.33934.231.029.528.12927.024.222.721.54034.831.429.928.43027.825.123.622.07、胎儿第四脑室正常范围胎儿第四脑室 宽径： 0.480.11mm， 前后径：0.270.0895%百分区间范围 宽径： 0.31-0.68 前后径：0.15-0.418、胎儿眼部生物学测量正常值孕周5th眼外距50th95th5th眼内距50th95th5th眼距50th95th125132349131361381525591424714101828510143581513203061014469161
17、522326101557917172534611155810181927377111669111922293971216791220243141812178101321263343813178111322283544913189121423303746914181012152431394810141910131525334150101519111316263542511115201214162736445311162012141728384554121621131517293947561217211315183041485713172214161831425058131822141619324
18、351601418231417193345526114192315171934465362151924151720354754631520241518203648556416202516182037495665162125161821385057651721261618213950586617222616192140515967182226161921孕20周前，眼外距=眼内距=眼间距； 孕20周后，眼内距略大于眼外距9、胎儿孕期鼻骨正常值孕周百 分 位 数孕周百 分 位 数5th50th95th5th50th95th121.82.84.2287.69.812.1142.53.85.3307.
19、91012.6163.44.76.2328.610.513.6184.35.77349.110.912.8205.26.78.3367.810.912.8225.87.59.3389.311.715.7246.88.3104010.412.114.5267.48.910.910、胎儿胸围的5、50、95百分位（妇产科超声学第5版）孕周5th50th95th孕周5th50th95th166.49.111.92918.22123.7177.31012.83019.121.924.6188.21113.7312022.825.5199.111.914.63220.923.726.4201012.81
20、5.53321.824.627.3211113.716.43422.825.528.22211.914.617.33523.726.429.12312.815.518.23624.627.3302413.716.419.13725.528.230.92514.617.3203826.429.131.92615.518.2213927.33032.82716.419.121.94028.230.933.72817.32022.8正常胎儿心围/胸围约等于0.40 胎儿心脏面积/胸围面积约为0.25-0.33。胸围与腹围的正常比值在0.83-0.95，胸围与头围的正常比值在0.68-0.92。11、
21、锁骨长度参考值（cm）medison孕周生长参数最小值最大值孕周生长参数最小值最大值353.63.14.1383.93.44.4363.73.24.23943.54.5373.83.34.3404.13.64.612、正常胎儿不同孕周胃泡大小（cm 李胜利书）妊娠龄（周）例数前后径长径13-15150.3-0.50.6-1.216-18290.4-0.80.9-1.719-21170.6-1.01.1-2.122-24110.6-1.21.3-2.525-27140.5-1.51.3-3.328-30170.9-1.51.8-1.831-33181.1-1.71.9-3.734-36151.0
22、-1.81.9-3.737-39161.2-2.02.3-4.113、正常胎儿不同孕周胆囊大小（cm 李胜利书）妊娠龄（周）长径横径15-191.00.320-221.50.423-241.90.625-262.10.627-302.10.731-342.60.735-402.70.6514、胎儿各孕周脾的长度测值（cm 李胜利书）妊娠龄（周）第五百分位均值第95百分位180.71.42.1201.11.82.6221.52.22.9241.92.53.2262.02.73.4282.43.13.8302.73.44.1323.13.84.5343.54.35.0364.14.85.5384.
23、75.46.2405.56.27.015、胎儿孕龄小肠和降结肠直径 mm孕周（周数）小肠腔大小结肠腔大小平均数最大值平均数最大值10-151.011.5215-201.223.6520-251.424.4625-301.838.01330-352.9611.41635-403.7816.826404.4818.72816、正常胎儿不同孕周肾脏径线测值前后径横径纵径孕周5th50th95th5th50th95th5th50th95th1626106101371318173711610141015201848126101412172219591371014141924206101371115152
24、126216101481215172228227111581216192429238121691317212631249131710141822283325101418111519242934261115191216192531362711151912162027323728121620131721283338291317211418222935403014182215192331364131141822162024323742321519231720243338433316202317212534394434162024182226354045351721251822263541463617
25、212519232736414737182226192327374247381822261923273743483919232719232738434840192327192327384449孕24周 肾脏长2.2-2.7cm, 孕32周 肾脏长2.8-3.3cm，孕足月，肾脏长3.6-4.1cm，肾周长/ 腹围 0.27-0.3317、正常胎儿四肢长骨12-40周胎儿四肢长骨第5、50、95百分位测值mm（李胜利书）孕周股骨胫骨腓骨肱骨尺骨桡骨5th50th95th5th50th95th5th50th95th5th50th95th5th50th95th5th50th95th124813769
26、771361116109611165101561014149141871217612199141981318813171512172191520915211217221116211115201615202412172213182315202513182313182217182327152025132128182227162126142026182125301722271523312025301924291522291924283320253019263323283321263120242920263136222733212836253035242934222732212934382530352
27、431372833382631362429332232364127323827333930354028333827313423353944303540283542333842313641263239243742463237412937453540453338432634422540444934404534404537424735404531364126424751374247364247394449374247323743274549543944493744504146513944493339452847525641465138455343485341465133404829505459434
28、853414754455055434853364247305256614550554349564751564449543643493154596347525742515948535846515638445032566165485459425263505560485358374553335863675055604654625156614954594146513460656952576246556553586351566140475335626771535864515762545964525762414854366468735560655458635661655358633948573765707
29、4566167545965576267556065454953386771765863685661655963685661664549543968737759646956626760657057626745505440707479616671596367616671586368465055(1) 染色体异常胎儿的长骨异常主要表现为肱骨短。(2) 胎儿短肢畸形时,肱骨测量不适用于推测孕周。(3) 股骨与肱骨测值低于平均值2倍标准差以上，可认为股骨或肱骨短。低于平均值2倍标准差以上5mm，则可能有骨骼发育不良。18、不同孕周胎儿足长百分位数mm （2000年）超声5版孕周10th50th90th孕
30、周10th50th90th孕周10th50th90th1515182223384246315963671617212524414549326165691720242825444851336468711823273126475154346670741926303327495357356973762029323628525659367175792132353929545862377477812235394230576164（1） 当FL/ 足长 0.85 时，提示胎儿染色体异常，该指标在孕1624周较为敏感。（2） 正常FL/ 足长比值 0.871.11（3） 当FL/FOOT 0.87 ；FL/
31、AC 16提示股骨过短19、正常羊水指数可信区间（cm 妇产科超声学 第五版）孕周5th50th95th孕周5th50th95th孕周5th50th95th167.912.118.5259.714.722.1348.114.224.8178.312.719.4269.714.722.3357.914.024.9188.713.320.2279.514.622.6367.713.824.9199.013.720.7289.414.622.8377.513.524.4209.314.121.2299.214.523.1387.313.223.9219.514.321.4309.014.523.43
32、97.212.722.6229.714.521.6318.814.423.8407.112.321.4239.814.621.8328.614.424.2417.011.619.4249.814.721.9338.314.324.5426.911.017.520、脐静脉平均流速（cm/s）妇产科超声学第五版孕周平均流速孕周平均流速孕周平均流速5th50th95th5th50th95th5th50th95th205.77.910.7276.569.0312.18347.4110.1613.66215.828.0610.9286.689.1912.39357.5310.3213.87225.948.2211.1296.8
