2021年婦兒超聲檢查手冊(超聲正常值)

婦兒超聲查抄手冊（超聲正常值）

美中宜和婦兒醫(yī)院超聲查抄手冊

一、正常早孕期

1.孕齡計算公式孕天數(shù)=胎囊平均內(nèi)徑（長+寬+厚）/3（mm）+30±3天

2.孕齡計算公式孕天數(shù)=孕囊最大經(jīng)線+3天

此兩個測量公式合用于孕7周之內(nèi)，但有必然誤差。

3.孕齡（天）=CRL+42

4.孕齡（周）=CRL+6.5

此兩公式合用于孕7-12周。測量時不包羅卵黃囊及肢體，取胚胎軀體最長最直的正中矢

面圖，測量最長經(jīng)線，最好取三次測量平均值。

5.胎囊逐日生長速度：1-1.5mm/d

6.正常早中期超聲孕周可見

孕周胚胎大小mm正常超聲所見

5可見小胎囊及卵黃囊，胎囊約占宮腔1/4

63.2胎囊清晰可見，可見卵黃囊、胎芽及胎心

79.3清楚可見胎芽、胎心，胎囊約占宮腔1/3

815.7可區(qū)分胎頭、胎體，胎囊約占宮腔1/2,可見蠕動

胎囊?guī)缀跽紳M宮腔，胚胎輪廓清晰，胎頭、腦泡及肢

922.6

芽可見

1030.7胚胎肢芽清晰可見，活躍于羊水中，胎盤最先形成

胎囊完全消散，胎盤清晰可見，四肢骨，指趾清晰可

1140.6

見

1252.8胎兒顱骨光環(huán)清晰，脊柱及四腔心可見

簡單記憶:5囊6芽7心8動9胎盤

7.胎兒中斷發(fā)育

胎囊平均內(nèi)徑N2.5cm,未見胎芽或胎芽長NO.6cm,未見胎心搏動。

注重：察看胎心搏動要在2分鐘以上

8.胎兒妊娠結(jié)局不良

(1)孕囊平均內(nèi)徑?CRLV5mm

(2)孕早期胎心率V80bpm

9.胎兒NT增厚

測量范疇：頭臀長44mm-85mm相當于孕11周2天-14周3天正常NT皂3.

0mm

50%的21三體，25%的18三體及10%的turner綜合癥NT或NF增厚

對于高齡孕婦(年紀大于35歲)，唐氏高危者，孕11-12周，NT>2.5mm,思量增

寬。

二、產(chǎn)前篩查(孕11?14周)要求

測量胎兒頭臀長并預(yù)計孕周

胎兒矢狀面測量NT厚度和鼻骨的表現(xiàn)

胎兒側(cè)腦室表現(xiàn)

表現(xiàn)胎兒心臟、胃泡

表現(xiàn)胎兒四肢

此期可篩查出的畸形：無腦兒、全前腦、腦膨出、四肢反常、NT增厚

參加查抄胎兒NT增厚，注重胎兒鼻骨有無缺失或過短，有無三尖瓣反流。NT增厚應(yīng)

建議做羊穿查抄。

三、孕中期胎兒篩查要求

1、頭部

（1）顱骨

大?。弘p頂徑平面測量

形態(tài)：正常為橢圓形，無局部突出或缺失，無檸檬頭或草莓頭

完整性：無骨質(zhì)缺損

骨密度：回聲過弱或過強應(yīng)思量顱骨質(zhì)礦化問題，如成骨不全、低磷酸酯酶癥等。

（2）腦結(jié)構(gòu)

側(cè)腦室水平橫斷面：察看腦中線、脈絡(luò)叢、側(cè)腦室、透明隔

丘腦水平橫斷面：丘腦、透明隔、

經(jīng)小腦橫切面：小腦橫徑、小腦蚓部、大腦延髓池

顱底橫切面:大腦腳Wellis環(huán)

顱腦正中矢狀切面:丘腦、咖氐體

2、脊柱

表現(xiàn)整個脊柱頸椎、胸椎、腰椎、尾椎（矢狀、冠狀切面）

膀胱水平橫切面表現(xiàn)三個骨化中間的布列

3、面部

上唇的完整性、雙眼眶、面部輪廓、口唇、亮孔矢狀面表現(xiàn)鼻骨

4、頸部

察看頸部有無腫物，如頸部水囊瘤或畸胎瘤

5、胸部

胸廓形態(tài)法則，肋骨自然彎曲，無短肋；雙肺回聲平均，無縱膈或腫物；膈肌呈線狀回聲,

分隔胸腹部臟器。

6、心臟

正常四腔心，對稱，左右室流出道，無膈疝證據(jù)，心率

7、腹部

胃泡位置正常，腸管無擴張，雙腎、膀胱均表現(xiàn)；臍帶腹壁入口處可見

8、肢體

表現(xiàn)雙上肢、雙下肢、雙手、雙足及其毗鄰關(guān)系

9、其他

胎盤：位置，有無腫物及副胎盤宮頸內(nèi)口長度、形態(tài)

臍帶：三根血管

外生殖器、宮頸、子宮形態(tài)及附件

（斜體部分為產(chǎn)前診斷要求）

四、胎兒生物測量正常值

1、胎兒頭臀長與孕周

孕周CRL孕周CRL孕周CRL孕周CRL孕周CRL

1。周。天3.喧周。

4.0512周0天5.2513周0天6.6514周0天7.95

1。周I天3.15髀

4.1512周1天5.4513周1天6.7514周1天8.05

周2

10周2天3.4.4512周2天5.6513周2天7.0514周2天8.35

天

45?周3

10周3天3.4.5512周3天5.8513周3天7.1514周3天8.45

天

二」1周4

10周4天3.UU-P-4.6512周4天5.9513周4天7.3514周4天&55

天

1。周5天3.75M5

4.8512周5天6.2513周5天7.5514周5天&75

10周6天3.852周65.0512周6天6.

3513周6天7.6514周6天8.85

天

2、正常胎兒雙頂徑、頭圍、腹圍、股骨長（medison）

孕周雙頂徑頭圍腹圍股骨長

131.90-2.347.2-8.86.3-7.41.00-1.33

142.35-2.748.9-10.407.5-8.61.34-1.66

10.4511.

152.78-3.178.7-9.81.67-1.99

95

163.18-3.5511.96-13.49.9-11.02.00-2.30

13.45-14.

173.56-3.9111.1-12.22.31-2.59

79

183.92-4.2614.8-16.1912.3-13.42.61-2.90

194.27-4.6016.2-17.3913.5-14.62.91-3.19

17.40-18.

204.61-4.9314.7-15.73.20-3.46

59

18.60-19.

214.95-5.2415.8-16.93.47-3.74

75

19.76-20.

225.25-5.5417.0-18.03.75-4.00

84

20.85-21.

235.55-5.8418.1-19.14.01-4.26

89

21.90-22.

245.85-6.1419.2-20.34.27-4.49

89

22.90-23.

256.15-6.4120.4-21.44.50-4.74

89

23.90-24.

266.42-6.6821.5-22.54.75-4.99

80

24.81-25.

276.69-6.9422.6-23.63.00-5.25

69

25.70-26.

286.95-7.2023.7-24.75.26-5.47

59

26.60-27.

297.21-7.4624.8-25.75.48-5.69

40

27.40-28.

307.47-7.6925.8-26.85.70-5.94

19

28.20-28.

317.70-7.9526.9-27.85.95-6.15

90

29.00-29.6.16-6.

327.96-8.1927.9-28.9

7036-

29.80-30.

338.20-8.4229.0-30.06.37-6.59

49

30.60-31.

348.43-8.6530.1-30.96.60-6.79

20

31.30-31.

358.66-8.8831.0-32.06.80-7.00

80

31.90-32.

368.89-9.1032.1-33.07.01-7.20

59

32.60-33.

379.11-9.3233.1-34.07.21-7.40

20

33.30-33.

389.33-9.5334.1-35.07.41-7.60

89

33.90-34.

399.54-9.7535.1-36.07.61-7.80

50

34.60-35.

409.76-9.9636.1-36.97.81-8.00

10

9.97-10.35.20-35.

4137.0-37.98.01-8.2

1670

4210.17-38.0

(1)BPD孕31周前，每周增加約3mm,孕31-36周增加1.5mm/周，孕36周后，增

加1mm/周；在孕12-28周測值最接近孕周。受胎方位、差別頭形或胎頭入盆等身分影

響，孕晚期BPD測值會出現(xiàn)較大毛病。

(2)孕30周前FL增加2.7mm/周，31-36周增加2mm/周，36周后增加1mm/周。

3、超聲參數(shù)解讀：

(1)頭徑指數(shù)。1=頭短軸徑BPD/頭長軸徑OFD正常范疇70%-86%

頭徑指數(shù)在正常范疇時，BPD適合評估體重。

頭徑指數(shù)小于70%或大于86%時，應(yīng)該用頭圍來評估體重。

(2)FL/AC正常20%?24%

FL/AC<20%大概為巨大兒FL/AC>24%大概有IUGR,應(yīng)放棄AC測量

(3)FL/BPD正常71%?87%

如FL/BPD<70%,則放棄FL測量

如FL/BPD>87%,則放棄BPD測量

(4)HC/AC正常0.96?1.17

正常孕35周前，腹圍小于頭圍：孕35周左右，比值根基相等；孕35周后，腹

圍大于頭圍。

(5)FL/HC小于3SD提示骨發(fā)育不良。

4、胎兒小腦橫徑正常值(參考美國婦產(chǎn)科學1987年)

孕周10th50th90th孕周10th50th90th孕周10th50th90th

161416172422252832333842

171617182523282933324044

181718192625293234334044

1918192227263032353140.547

201820222827313436364355

211922242929343837374555

2221232430313540384048.555

232224263132384339525255

孕24周前，小腦橫徑約等于孕周,孕20-38周，平均增加約1-2mm/周；孕24周后，小

腦橫徑值顯明大于孕周，妊娠38周后，平均增加約0.7mm/周。

5、胎兒小腦蚓部正常值

孕周（周）前后徑（mm）頂尾徑（mm）周長（mm）面積(cm2)

21-2210.6±1.411.1±1.143.8±3.30.9±0.2

23-2412.9±1.112.3±1.447.5±5.51.2±0.2

25-2613.5+2.113.6+0.950.9+4.41.4+0.2

27-2816.3±2.716.0±1.658.9±6.82.0±0.5

29-3017.5±2.217.7±2.164.7±6.52.3±0.4

31-3219.0±1.919.2±1.170.7±6.92.8±0.4

33-3419.2±1.919.8±1.072.7±8.33.0±0.8

35-3621.4±1.521.2±2.377.6±5.13.4±0.3

37-3822.1±3.823.0±4.680.7±9.93.9±1.4

39-4025.7±2.325.0±2.686.7±7.04.9±0.7

6、診斷小頭畸形頭圍參考值（cm李勝利）

孕周正常-2SD-3SD-4SD孕周正常-2SD-3SD-4SD

201814.513.111.63128.626.024.523.0

2119.215.714.312.83229.426.825.323.9

2220.316.915.414.03330.227.626.124.6

2321.418.016.615.13430.928.326.825.3

2422.419.117.716.23531.528.927.526.0

2523.420.218.817.33632.429.528.126.6

2624.421.319.818.33732.930.128.627.2

2725.322.320.819.43833.930.629.127.6

2826.223.321.820.33934.231.029.528.1

2927.024.222.721.54034.831.429.928.4

3027.825.123.622.0

7、胎兒第四腦室正常范疇

胎兒第四腦室寬徑：0.48±0.11mm,前后徑:0.27±0.08

95%百分區(qū)間范疇寬徑：0.31-0.68前后徑：0.15-0.41

8、胎兒眼部生物學測量正常值

眼外距眼內(nèi)距眼距:

孕周

5th50th95th5th50th95th5th50th95th

12513234913136

13815255914247

1410182851014358

1513203061014469

1615223261015579

17172534611155810

18192737711166911

19222939712167912

202431418121781013

212633438131781113

222835449131891214

2330374691418101215

24313948101419101315

25334150101519111316

26354251111520121416

27364453111620121417

28384554121621131517

29394756121721131518

30414857131722141618

31425058131822141619

32435160141823141719

33455261141923151719

34465362151924151720

35475463152024151820

36485564162025161820

37495665162125161821

38505765172126161821

39505866172226161921

40515967182226161921

孕20周前，眼外距=眼內(nèi)距=眼間距;孕20周后，眼內(nèi)距略大于眼外距

9、胎兒孕期鼻骨正常值

百分位數(shù)百分位數(shù)

孕周孕周

5th50th95th5th50th95th

121.82.84.2287.69.812.1

142.53.85.3307.91012.6

163.44.76.2328.610.513.6

184.35.77349.110.912.8

205.26.78.3367.810.912.8

225.87.59.3389.311.715.7

246.88.3104010.412.114.5

267.48.910.9

10、胎兒胸圍的5、50、95百分位（婦產(chǎn)科超聲學第5版）

孕周5th50th95th孕周5th50th95th

166.49.111.92918.22123.7

177.31012.83019.121.924.6

188.21113.7312022.825.5

199.111.914.63220.923.726.4

201012.815.53321.824.627.3

211113.716.43422.825.528.2

2211.914.617.33523.726.429.1

2312.815.518.23624.627.330

2413.716.419.13725.528.230.9

2514.617,3203826.429.131.9

2615.518.2213927.33032.8

2716.419.121.94028.230.933.7

2817.32022.3

正常胎兒心圍/胸圍約等于0.40胎兒心臟面積/胸圍面積約為0.25-0.33。

胸圍與腹圍的正常比值在0.83-0.95,胸圍與頭圍的正常比值在0.68-0.92

11、鎖骨長度參考值（cm）medison

生長參生長參

孕周最小值最大值孕周最小值最大值

數(shù)數(shù)

353.63.14.1383.93.44.4

363.73.24.23943.54.5

373.83.34.3404.13.64.6

12、正常胎兒差別孕周胃泡大?。╟m李勝利書）

妊娠齡（周）例數(shù)前后徑長徑

0.3-0.

13-15150.6-1.2

5

0.4-0.

16-18290.9-1.7

8

0.6-1.

19-211/1.1-2.1

0

0.6-1.

22-24111.3-2.5

2

0.5-1.

25-27M1.3-3.3

5

0.9-1.

28-30171.8-1.8

5

1.1-1.

31-33181.9-3.7

7

1.0-1.

34-36151.9-3.7

8

1.2-2.

37-39162.3-4.1

0

13、正常胎兒差別孕周膽囊大小（cm李勝利書）

奸娠齡（周）長徑橫杼

15-191.00.3

20-221.50.4

23-241.90.6

25-262.10.6

27-302.10.7

31-342.60.7

35-402.70.65

14、胎兒各孕周脾的長度測值（cm李勝利書）

妊娠齡（周）第五百分位均值第95百分位

180.7L42.1

201.11.82.6

221.52.22.9

241.92.53.2

262.02.73.4

282.43.13.8

302.73.44.1

323.13.84.5

343.54.35.0

364.14.85.5

384.75.46.2

405.56.27.0

15、胎兒孕齡小腸和降結(jié)腸直徑mm

小腸腔大小結(jié)腸腔大小

孕周

（周數(shù)）

平均數(shù)最大值平均數(shù)最大值

10-151.011.52

15-201.223.65

20-251.424.46

25-301.838.013

30-352.9611.416

35-403.7816.826

>404.4818.728

16、正常胎兒差別孕周腎臟徑線測值

前后徑橫徑縱徑

孕周5th50th95th5th50th95th5th50th95th

1626106101371318

17371161014101520

18481261014121722

19591371014141924

206101371115152126

216101481215172228

227111581216192429

238121691317212631

2491317101418222833

25101418111519242934

26111519121619253136

27111519121620273237

28121620131721283338

29131721141822293540

30141822151923313641

31141822162024323742

32151923172024333843

33162023172125343944

34162024182226354045

35172125182226354146

36172125192327364147

37182226192327374247

38182226192327374348

39192327192327384348

40192327192327384449

孕24周腎臟長2.2-2.7cm,孕32周腎臟長2.8-3.3cm,孕足月，腎臟長3.6-4.1cm,

腎周長/腹圍0.27-0.33

17、正常胎兒四肢長骨

12-40周胎兒四肢長骨第5、50、95百分位測值mm（李勝利書）

孕周股骨脛骨腓骨肱骨尺骨槎骨

5th50th95th5th50th95th5th50th95th5th50th95th5th50th95th5th50th95th

12481376977

1361116109611165101561014

14914187121761219914198131881317

151217219152091521121722111621111520

16152024121722131823152025131823131822

17182327152025132128182227162126142026

18212530172227152331202530192429152229

19242833202530192633232833212631202429

20263136222733212836253035242934222732

21293438253035243137283338263136242933

22323641273238273339303540283338273134

23353944303540283542333842313641263239

24374246323741293745354045333843263442

25404449344045344045374247354045313641

26424751374247364247394449374247323743

27454954394449374450414651394449333945

28475256414651384553434853414651334048

29505459434853414754455055434853364247

30525661455055434956475156444954364349

31545963475257425159485358465156384450

32566165485459425263505560485358374553

33586367505560465462515661495459414651

34606569525762465565535863515661404753

35626771535864515762545964525762414854

36646873556065545863566165535863394857

37657074566167545965576267556065454953

38677176586368566165596368566166454954

39687377596469566267606570576267455054

40707479616671596367616671586368465055

(1)染色體反常胎兒的長骨反常主要表現(xiàn)為肱骨短。

(2)胎兒短肢畸形時，肱骨測量不合用于推斷孕周。

(3)股骨與肱骨測值低于平均值2倍標準差以上，可認為股骨或肱骨短。低于平均值

2倍標準差以上5mm,則大概有骨骼發(fā)育不良。

18、差別孕周胎兒足長百分位數(shù)mm(2000年)超聲5版

孕周10th50th90th孕周10th50th90th孕周10th50th90th

151518222338424631596367

161721252441454932616569

172024282544485133646871

182327312647515434667074

192630332749535735697376

202932362852565936717579

213235392954586237747781

2235394230576164

(1)當FL/足長v0.85時，提示胎兒染色體反常，該指標在孕16—24周較為

敏感。

(2)正常FL/足長比值0.87—1.11

(3)當FL/FOOT<0.87；FL/AC&16提示股骨過短

19、正常羊水指數(shù)可信區(qū)間(cm婦產(chǎn)科超聲學第五版)

孕周5th50th95th孕周5th50th95th孕周5th50th95th

167.912.118.5259.714.722.1348.114.224.8

178.312.719.4269.714.722.3357.914.024.9

188.713.320.2279.514.622.6367.713.824.9

199.013.720.7289.414.622.8377.513.524.4

209.314.121.2299.214.523.1387.313.223.9

219.514.321.4309.014.523.4397.212.722.6

229.714.521.6318.814.423.8407.112.321.4

239.814.621.8328.614.424.2417.011.619.4

249.814.721.9338.314.324.5426.9IL017.5

20、臍靜脈平均流速(cm/s)婦產(chǎn)科超聲學第五版

平均流速平均流速平均流速

孕周孕周孕周

5th50th95th5th50th95th5th50th95th

205.77.910.7276.569.0312.18347.4110.1613.66

215.828.0610.9286.689.1912.39357.5310.3213.87

225.948.2211.1296.89.3512.6367.6510.4814.08

236.078.3811.3306.929.5112.81377.7810.6414.29

246.198.5411.5317.049.6713.02387.910.814.5

256.318.7111.8327.179.8313.23398.0210.9614.71

266.438.8712337.299.9913.44408.1411.1214.92

21、大腦中動脈多普勒評估胎兒貧血

差別等級的貧血所對應(yīng)的大腦中

動脈收縮期血流峰值閾值cm/s

孕周

正常2度貧中度貧血重度貧血

1823.229.934.836

2025.532.838.239.5

2227.93641.943.3

2430.739.54647.5

2633.643.350.452.1

2836.947.655.457.2

3040.552.560.762.8

3244.457.366.668.9

3448.762.973.175.6

3653.56980.282.9

3858.775.78891

4064.48396.699.8

22、臍動脈阻力指數(shù)和S/D正常值（婦產(chǎn)科超聲學）

阻力指數(shù)S/D

孕周

5th50th95th5th50th95th

160.70.80.93.395.1210.5

170.690.790.893.274.869.46

180.680.780.883.164.638.61

190.670.770.873.064.417.9

200.670.760.862.974.227.3

210.650.750.852.884.046.78

220.640.740.842.793.886.33

230.630.730.832.713.735.94

240.620.720.822.643.595.59

250.610.710.812.573.465.28

260.60.700.82.53.345.01

270.590.690.792.443.224.76

280.580.670.782.383.124.53

290.570.670.772.323.084.33

300.560.670.762.262.934.14

310.550.650.752.212.843.97

320.540.640.742.162.763.81

330.530.630.732.112.683.67

340.520.620.722.072.613.53

350.510.610.712.032.543.4

360.500.600.701.982.473.29

370.490.590.691.942.413.18

380.470.570.671.902.353.08

390.460.560.671.872.302.98

400.450.550.651.832.242.89

410.440.540.641.802.192.81

420.430.530.631.762.142.73

23、大腦中動脈阻力指數(shù)的參考值

孕周5th50th95m孕周5th50th95th

180.540.690.79310.650.800.91

190.570.710.81320.650.790.90

200.590.730.83330.640.780.89

210.610.740.85340.630.770.89

220.620.760.86350.610.760.87

230.630.770.87360.600.750.86

240.640.780.89370.580.730.84

250.650.790.90380.560.710.83

260.660.800.90390.540.690.81

270.660.800.91400.520.670.79

280.660.800.91410.490.640.76

290.660.800.91420.460.620.74

300.660.800.91

24、子宮動脈阻力指數(shù)與搏動指數(shù)

孕阻力指數(shù)搏動指數(shù)

周5th50th95th50th9

5th5th

1

0.220.450.660.510.891.41

8

1

0.200.430.640.460.841.36

9

2

0.190.420.630.440.811.33

0

2

0.190.410.620.420.801.31

1

2

0.180.410.620.410.781.29

2

2

0.180.400.610.400.771.28

3

2

0.170.400.610.390.761.27

4

2

0.170.390.600.380.751.26

5

2

0.160.390.600.370.741.25

6

2

0.160.390.b90.370.741.24

7

2

0.160.380.590.360.731.23

8

2

0.150.380.590.360.721.22

9

3

0.150.380.580.350.721.21

0

3

0.150.370.580.350.711.21

1

3

0.150.370.580.350.711.20

2

3

0.150.370.580.340.701.19

3

3

0.140.370.570.340.701.19

4

3

0.140.360.570.33