三维容积超声成像评估胎儿胸腺发育的研究
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摘要
目的利用三维超声建立胎儿胸腺体积的正常参考值并探讨胸腺发育与胎儿异常的相关性。方法产前超声检测340例正常胎儿和42例异常胎儿(心脏异常23例,其他异常19例)的胸腺三维体积。线性回归分析正常胎儿胸腺体积和孕周的相关性,并建立正常参考值,胸腺体积低于同孕周正常值第5百分点定为胸腺发育不良,P<0.05为差异有统计学意义。结果 (1)正常胎儿三维胸腺体积与孕周呈直线相关,回归方程Y=-13.023+0.659X,P<0.05。(2)42例异常胎儿中发现2例胸腺缺如,23例胸腺发育不良,17例胸腺发育正常。胸腺发育异常胎儿中合并心脏异常占17例,2例胸腺缺如均证实为22q11.2微缺失。结论 (1)正常胎儿胸腺体积随孕周增加呈线性增长。(2)胎儿异常与胸腺发育不良或缺如具有一定相关性,尤其先天性心脏病和22q11.2微缺失。
Objective To establish reference range for fetal thymus volume by the method of three-dimensional volume ultrasound,and to explore the correlation between thymus development and fetal abnormality.Methods The three-dimensional volume of 340 normal fetuses and 42 abnormal fetuses was measured by prenatal ultrasound,including cardiac abnormality 23 cases and the other 19 cases.Linear regression analysis was used to analyze the correlation between the three-dimensional volume of normal fetal thymus and gestational weeks and to establish the normal reference range.The fetal thymus volume below the 5 th percentile of the gastational age is defined as fetal thymic hypoplasia(P<0.05).Results The three dimensional thymus volume of normal fetus was linear correlated with gestational weeks,equation was Y=-13.023+0.659 X,P<0.05.Of the 42 abnormal fetuses,2 cases were found to be thymic aplasia,23 cases were fetal thymus hypoplasia and 17 cases had normal thymus size.Among thymic hypoplasia or aplasia fetuses,17 cases associated with heart abnormalities,and 2 thymic aplasia fetuses were confirmed as 22 q11.2 microdeletion.Conclusions The volume of normal fetal thymus increases linearly with the increase of gestational week.Fetal abnormalities were associated with thymic hypoplasia or absence,especially 22 q11.2 microdeletion and congenital heart disease.
Objective To establish reference range for fetal thymus volume by the method of three-dimensional volume ultrasound,and to explore the correlation between thymus development and fetal abnormality.Methods The three-dimensional volume of 340 normal fetuses and 42 abnormal fetuses was measured by prenatal ultrasound,including cardiac abnormality 23 cases and the other 19 cases.Linear regression analysis was used to analyze the correlation between the three-dimensional volume of normal fetal thymus and gestational weeks and to establish the normal reference range.The fetal thymus volume below the 5 th percentile of the gastational age is defined as fetal thymic hypoplasia(P<0.05).Results The three dimensional thymus volume of normal fetus was linear correlated with gestational weeks,equation was Y=-13.023+0.659 X,P<0.05.Of the 42 abnormal fetuses,2 cases were found to be thymic aplasia,23 cases were fetal thymus hypoplasia and 17 cases had normal thymus size.Among thymic hypoplasia or aplasia fetuses,17 cases associated with heart abnormalities,and 2 thymic aplasia fetuses were confirmed as 22 q11.2 microdeletion.Conclusions The volume of normal fetal thymus increases linearly with the increase of gestational week.Fetal abnormalities were associated with thymic hypoplasia or absence,especially 22 q11.2 microdeletion and congenital heart disease.
引文
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[6]ATALAY E,CENK C,CUNEYT E,et al.Prognostic value of fetal thymus size in intrauterine growth restriction[J].J Ultrasound Med,2016,35(3):511-517.
[7]EVISTON D P,QUINTON A E,BENEIE R J,et al.Impaired fetal thymic growth precedes clinical preelampsia:a case-control study[J].J Reprod Immunol,2012,94(2):183-189.
[2]吕国荣,李伯义,李丽雅,等.超声评估心脏畸形及感染胎儿的胸腺发育[J].中国超声医学杂志,2011,27(5):451-454.
[3]MOHAMED N,EVISTON D P,QUINTON A E,et al.Smaller fetal thymuses in preeclampsia:aprospective cross-sectional study[J].Ultrasound Obstet Gynecol,2011,37(4):410-415.
[4]AKSAKAL S E,KANDEMIR O,ALTINBAS S,et al.Fetal thymus size as a predictor of histological chorioamnionitis in preterm premature rupture of membranes[J].J Matern Fetal Neonatal Med,2014,27(11):1118-1122.
[5]KARL K,HELING K.S,LOPEZ A,et al.Thymic-thoracic ratio in fetuses with trisomy 21,18or 13[J].Ultrasound Obstet Gynecol,2012,40(4):412-417.
[6]ATALAY E,CENK C,CUNEYT E,et al.Prognostic value of fetal thymus size in intrauterine growth restriction[J].J Ultrasound Med,2016,35(3):511-517.
[7]EVISTON D P,QUINTON A E,BENEIE R J,et al.Impaired fetal thymic growth precedes clinical preelampsia:a case-control study[J].J Reprod Immunol,2012,94(2):183-189.