摘要
目的:评价妊娠11周~13周6天早孕期超声筛查常规切面所能获得的超声标志筛查胎儿开放性脊柱裂(open spina bifida,OSB)的应用价值。方法:回顾并分析2020年6月—2021年12月在复旦大学附属妇产科医院杨浦院区建卡产检的6例脊柱裂胎儿[OSB 3例,闭合性脊柱裂(closed spina bifida,CSB)3例]和30例正常胎儿的医学资料。调取早孕期超声筛查存储的图像,选取颅脑正中矢状切面和侧脑室切面,观察颅脑正中矢状切面的“四线征”“上颌骨-枕骨线”这两个定性超声标志,侧脑室切面分析定量超声指标“脉络膜长度与枕额径比值(ratio of mean choroid plexus length and occipitofrontal diameter,R-CP)”。对各组胎儿的3个标志再评价并结合妊娠结局进行对比。结果:在30例对照组胎儿和3例CSB胎儿中,均能显示“四线征”;中脑脑干联合处在上颌-枕骨线之上;R-CP为0.43~0.55;而3例OSB胎儿均表现为“三线征”,中脑脑干联合处在上颌骨-枕骨线之下,R-CP分别为0.62、0.68、0.67,显著高于对照组和CSB组胎儿(P<0.001)。结论:早孕期超声筛查常规切面所能获得的3种颅脑超声标志能有效地筛查胎儿OSB。
Objective:To evaluate cranial ultrasound markers in routine screening scan for open spina bifida(OSB)between 11 and 13+6 weeks of gestation.Methods:This was a retrospective study including 6 cases of spina bifida[three cases were OSB and the others were closed spina bifida(CSB)]and 30 controls in Obstetrics and Gynecology Hospital of Fudan University between June 2020 and December 2021.Indirect cranial markers of OSB were evaluated on stored ultrasound images and the medical records were reviewed.Four lines view(4LV)and maxillo-occipital(MO)line were assessed on the sagittal view,whereas the ratio of mean choroid plexus length and occipitofrontal diameter(R-CP)were measured on the axial plane.All cases of spina bifida or controls diagnosed prenatally were confirmed at birth or by autopsy.Results:The 4LV sign and the junction between the midbrain and the brain stem above the MO line on the sagittal view were found,and R-CP on the axial plane were between 0.43-0.55 in 3 CSB fetus and 30 controls.3LV and the junction between the midbrain and the brain stem below the MO line were seen and the R-CP were 0.62,0.68 and 0.67 in OSB fetus,which were significantly higher than the other groups(P<0.001).Conclusion:The 4LV and MO line on the sagittal view and R-CP on the axial plane appear to be the effective indirect cranial sonographic markers of OSB and can be easily obtained during the routine first-trimester scan.
作者
赵凡桂
任芸芸
ZHAO Fangui;REN Yunyun(Department of Ultrasound,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200011,China)
出处
《肿瘤影像学》
2023年第3期281-285,共5页
Oncoradiology
关键词
超声
开放性脊柱裂
早孕期
产前诊断
Ultrasound
Open spina bifida
First trimester
Prenatal diagnosis
