MRI测量正常中晚孕胎儿大脑主要径线的价值
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摘要
目的探讨3.0T MRI测量正常胎儿头颅主要径线的可重复性及其与孕周的相关性;建立MRI对正常胎儿大脑发育的量化评价方法。方法收集219胎超声检查初步提示胎脑解剖结构正常的胎儿。采用3.0T MR仪扫描胎儿颅脑。由2名MRI医师测量胎儿脑双顶径、脑额枕径、骨双顶径、骨额枕径、头围、胼胝体长度及小脑横径,评价观察者间的可重复性,并对胎儿颅脑主要径线与孕周相关性进行分析。结果 2名医师应用MRI测量胎儿颅脑主要径线的可重复性好(组内相关系数均>0.7);胎儿脑双顶径、脑额枕径、骨双顶径、骨额枕径、头围、胼胝体长度、小脑横径与孕周均呈正相关(r=0.957、0.974、0.949、0.959、0.971、0.887、0.985,P均<0.001)。结论 3.0T MR用于测量正常中晚孕胎儿大脑主要径线具有较好的可重复性;孕中晚期胎儿脑生物测量参数随孕龄呈二次多项式函数变化趋势。
Objective To explore the repeatability of measuring the main diameters of normal fetal head using 3.0 T MRI and the correlation with gestational age(GA), also to establish a quantitative evaluation method of MRI for the development of normal fetal brain. Methods Totally 219 fetuses with normal anatomic brain structure confirmed by ultrasound were enrolled and underwent 3.0 T MR scanning. Fetal brain biparietal diameter(BBD), brain fronto-occipital length(BFOL), skull biparietal diameter(SBD), skull fronto-occipitoal diameter(SFOD), head circumference(HC), length of the corpus callosum(LCC) and cerebellar transverse diameter(CTD) were measured by two radiologists. The repeatability of these two radiologists, and the correlation between the main diameters of fetal brain and gestational ages were analyzed. Results The main diameters of fetal brain measured by two observers were reproducible(all interclass correlation coefficient >0.7). BBD, BFOL, SBD, SFOD, HC, LCC and CTD had positive correlation with GA(r=0.957, 0.974, 0.949, 0.959, 0.971, 0.887, 0.985, all P<0.001). Conclusion 3.0 T MR has good reproducibility in measurement of the main diameters of fetal brain in normal middle and late pregnancy. There are quadratic polynomial functional relationships of the parameters of fetal brain biometry with GA.
Objective To explore the repeatability of measuring the main diameters of normal fetal head using 3.0 T MRI and the correlation with gestational age(GA), also to establish a quantitative evaluation method of MRI for the development of normal fetal brain. Methods Totally 219 fetuses with normal anatomic brain structure confirmed by ultrasound were enrolled and underwent 3.0 T MR scanning. Fetal brain biparietal diameter(BBD), brain fronto-occipital length(BFOL), skull biparietal diameter(SBD), skull fronto-occipitoal diameter(SFOD), head circumference(HC), length of the corpus callosum(LCC) and cerebellar transverse diameter(CTD) were measured by two radiologists. The repeatability of these two radiologists, and the correlation between the main diameters of fetal brain and gestational ages were analyzed. Results The main diameters of fetal brain measured by two observers were reproducible(all interclass correlation coefficient >0.7). BBD, BFOL, SBD, SFOD, HC, LCC and CTD had positive correlation with GA(r=0.957, 0.974, 0.949, 0.959, 0.971, 0.887, 0.985, all P<0.001). Conclusion 3.0 T MR has good reproducibility in measurement of the main diameters of fetal brain in normal middle and late pregnancy. There are quadratic polynomial functional relationships of the parameters of fetal brain biometry with GA.
引文
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[13] Behrman RE, Lees MH, Peterson EN, et al. Distribution of the circulation in the normal and asphyxiated fetal primate. Am J Obstet Gynecol, 1970,108(6):956-969.
[14] 刘菲,李振平,刘树伟,等.胎儿小脑发育的MRI研究及其意义.中国临床解剖学杂志,2010,28(2):155-158.
[2] Kyriakopoulou V, Vatansever D, Davidson AA, et al. Normative biometry of the fetal brain using magnetic resonance imaging. Brain Struct Funct, 2017,222(5):2295-2307.
[3] 严陈晨,朱斌,何健,等.正常胎儿大脑重要径线的MRI测量及意义.江苏医药,2012,10(6):25-28.
[4] Al-Obaidly S, Al-Ibrahim A, Saleh NA, et al. Third trimester ultrasound accuracy and delivery outcome in obese and morbid obese pregnat women. J Matern Fetal Neonatal Med, 2019,32(8):1275-1279.
[5] Rethmann C, Scheer I, Meuli M, et al. Evolution of posterior fossa and brain morphology after in utero repair of open neural tube defects assessed by MRI. Eur Radiol, 2017,27(11):4571-4580.
[6] Tilea B, Alberti C, Adamsbaum C, et al. Cerebral biometry in fetal magnetic resonance imaging: New reference data. Ultrasound Obstet Gynecol, 2009,33(2):173-180.
[7] Pier DB, Gholipour A, Afacan O, et al. 3D super-resolution motion-corrected MRI: Validation of fetal posterior fossa measurements. J Neuroimaging, 2016,26(5):539-544.
[8] 许丽梅,刘银梅.超声下不同孕周胎儿主要生长参数正常值范围及其生长曲线分析.中国妇幼保健,2017,32(7):1579-1581.
[9] Vasung L, Lepage C, Rados M, et al. Quantitative and qualitative analysis of transient fetal compartments during prenatal human brain development. Front Neuroanat, 2016,10:11.
[10] 黄小云,刘惠龙,雷敏,等.深圳16887例胎龄27～42周新生儿宫内生长体重、身长、头围、胸围、顶臀长曲线.中国当代儿科杂志,2017,19(8):877-886.
[11] Cignini P, Padula F, Giorlandino MA, et al. Reference charts for fetal corpus callosum length a prospective cross-sectional study of 2950 fetuses. J Ultrasound Med, 2014,33(6):1065-1078.
[12] da Gra?a AL, Cardoso KR, da Costa JM, et al. Assessment of gestational age using cerebellar measurements at cranial ultrasound: What is the best approach? Early Hum Dev, 2013,89(1):1-5.
[13] Behrman RE, Lees MH, Peterson EN, et al. Distribution of the circulation in the normal and asphyxiated fetal primate. Am J Obstet Gynecol, 1970,108(6):956-969.
[14] 刘菲,李振平,刘树伟,等.胎儿小脑发育的MRI研究及其意义.中国临床解剖学杂志,2010,28(2):155-158.