2021年妇儿超声检查手册(超声正常值)

妇儿超声查抄手册（超声正常值）

美中宜和妇儿医院超声查抄手册

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）+30±3天

2.孕龄计算公式孕天数=孕囊最大经线+3天

此两个测量公式合用于孕7周之内，但有必然误差。

3.孕龄（天）=CRL+42

4.孕龄（周）=CRL+6.5

此两公式合用于孕7-12周。测量时不包罗卵黄囊及肢体，取胚胎躯体最长最直的正中矢

面图，测量最长经线，最好取三次测量平均值。

5.胎囊逐日生长速度：1-1.5mm/d

6.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1/4

63.2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1/3

815.7可区分胎头、胎体，胎囊约占宫腔1/2,可见蠕动

胎囊几乎占满宫腔，胚胎轮廓清晰，胎头、脑泡及肢

922.6

芽可见

1030.7胚胎肢芽清晰可见，活跃于羊水中，胎盘最先形成

胎囊完全消散，胎盘清晰可见，四肢骨，指趾清晰可

1140.6

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.胎儿中断发育

胎囊平均内径N2.5cm,未见胎芽或胎芽长NO.6cm,未见胎心搏动。

注重：察看胎心搏动要在2分钟以上

8.胎儿妊娠结局不良

(1)孕囊平均内径・CRLV5mm

(2)孕早期胎心率V80bpm

9.胎儿NT增厚

测量范畴：头臀长44mm-85mm相当于孕11周2天-14周3天正常NT皂3.

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(年纪大于35岁)，唐氏高危者，孕11-12周，NT>2.5mm,思量增

宽。

二、产前筛查(孕11・14周)要求

测量胎儿头臀长并预计孕周

胎儿矢状面测量NT厚度和鼻骨的表现

胎儿侧脑室表现

表现胎儿心脏、胃泡

表现胎儿四肢

此期可筛查出的畸形：无脑儿、全前脑、脑膨出、四肢反常、NT增厚

参加查抄胎儿NT增厚，注重胎儿鼻骨有无缺失或过短，有无三尖瓣反流。NT增厚应

建议做羊穿查抄。

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：回声过弱或过强应思量颅骨质矿化问题，如成骨不全、低磷酸酯酶症等。

（2）脑结构

侧脑室水平横断面：察看脑中线、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、咖氐体

2、脊柱

表现整个脊柱颈椎、胸椎、腰椎、尾椎（矢状、冠状切面）

膀胱水平横切面表现三个骨化中间的布列

3、面部

上唇的完整性、双眼眶、面部轮廓、口唇、亮孔矢状面表现鼻骨

4、颈部

察看颈部有无肿物，如颈部水囊瘤或畸胎瘤

5、胸部

胸廓形态法则，肋骨自然弯曲，无短肋；双肺回声平均，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、膀胱均表现；脐带腹壁入口处可见

8、肢体

表现双上肢、双下肢、双手、双足及其毗邻关系

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

131.90-2.347.2-8.86.3-7.41.00-1.33

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，每周增加约3mm,孕31-36周增加1.5mm/周，孕36周后，增

加1mm/周；在孕12-28周测值最接近孕周。受胎方位、差别头形或胎头入盆等身分影

响，孕晚期BPD测值会出现较大毛病。

(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、超声参数解读：

(1)头径指数。1=头短轴径BPD/头长轴径OFD正常范畴70%-86%

头径指数在正常范畴时，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)FL/AC正常20%〜24%

FL/AC<20%大概为巨大儿FL/AC>24%大概有IUGR,应放弃AC测量

(3)FL/BPD正常71%〜87%

如FL/BPD<70%,则放弃FL测量

如FL/BPD>87%,则放弃BPD测量

(4)HC/AC正常0.96〜1.17

正常孕35周前，腹围小于头围：孕35周左右，比值根基相等；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10th50th90th

161416172422252832333842

171617182523282933324044

181718192625293234334044

1918192227263032353140.547

201820222827313436364355

211922242929343837374555

2221232430313540384048.555

232224263132384339525255

孕24周前，小脑横径约等于孕周,孕20-38周，平均增加约1-2mm/周；孕24周后，小

脑横径值显明大于孕周，妊娠38周后，平均增加约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)

21-2210.6±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、诊断小头畸形头围参考值（cm李胜利）

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、胎儿第四脑室正常范畴

胎儿第四脑室宽径：0.48±0.11mm,前后径:0.27±0.08

95%百分区间范畴宽径：0.31-0.68前后径：0.15-0.41

8、胎儿眼部生物学测量正常值

眼外距眼内距眼距:

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

百分位数百分位数

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、胎儿胸围的5、50、95百分位（妇产科超声学第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、锁骨长度参考值（cm）medison

生长参生长参

孕周最小值最大值孕周最小值最大值

数数

353.63.14.1383.93.44.4

363.73.24.23943.54.5

373.83.34.3404.13.64.6

12、正常胎儿差别孕周胃泡大小（cm李胜利书）

妊娠龄（周）例数前后径长径

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、正常胎儿差别孕周胆囊大小（cm李胜利书）

奸娠龄（周）长径横杼

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

180.7L42.1

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、胎儿孕龄小肠和降结肠直径mm

小肠腔大小结肠腔大小

孕周

（周数）

平均数最大值平均数最大值

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、正常胎儿差别孕周肾脏径线测值

前后径横径纵径

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0.27-0.33

17、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)染色体反常胎儿的长骨反常主要表现为肱骨短。

(2)胎儿短肢畸形时，肱骨测量不合用于推断孕周。

(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,则大概有骨骼发育不良。

18、差别孕周胎儿足长百分位数mm(2000年)超声5版

孕周10th50th90th孕周10th50th90th孕周10th50th90th

151518222338424631596367

161721252441454932616569

172024282544485133646871

182327312647515434667074

192630332749535735697376

202932362852565936717579

213235392954586237747781

2235394230576164

(1)当FL/足长v0.85时，提示胎儿染色体反常，该指标在孕16—24周较为

敏感。

(2)正常FL/足长比值0.87—1.11

(3)当FL/FOOT<0.87；FL/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、脐静脉平均流速(cm/s)妇产科超声学第五版

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、大脑中动脉多普勒评估胎儿贫血

差别等级的贫血所对应的大脑中

动脉收缩期血流峰值阈值cm/s

孕周

正常2度贫中度贫血重度贫血

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、脐动脉阻力指数和S/D正常值（妇产科超声学）

阻力指数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、大脑中动脉阻力指数的参考值

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、子宫动脉阻力指数与搏动指数

孕阻力指数搏动指数

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