中孕期胎儿透明隔腔消失的超声与MR诊断价值的相关性研究
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摘要
第一部分：中孕期胎儿的透明隔腔的超声基础测量
目的：对中孕期胎儿透明隔腔进行超声基础测量,包括中孕期内透明隔腔的正常值范围及透明隔腔与孕周、双顶径、头围、小脑横径间的关系。
材料与方法：对中孕期300例正常胎儿取侧脑室平面显示脑中线的前1/3处、侧脑室前角内一对平行的线性回声之间长方形或三角形的液性暗区即透明隔腔,测量其长径、宽径。3位从事产前诊断工作5年以上、资历相当的超声诊断医生采集图像,显示欠清晰时多次检查至得到满意切面,重复测量三次,取平均值计数。对孕周、双顶径、头围、小脑横径及透明隔腔数据进行统计学分析处理。结果：在300例胎儿中,透明隔腔显示率达100%,但共有256例成功测量了透明隔腔的长径与宽径,测量成功率为85.3%。256例正常胎儿透明隔腔长径测量值为1.23±0.32cm,范围由0.4cm至1.8cm,宽径为0.59±0.10cm,范围0.3cm～0.9cm。本研究中所测量的透明隔腔长径与孕周相关性小,宽径的均值在28w之前逐渐增宽,28周后略有减低。孕期各因素如孕周、双顶径、小脑横径、头围等与透明隔腔的长径、宽径间均呈现较低的相关性,而长径与其他因素的相关性较宽径的相关性更低,其中头围与透明隔腔宽径相关度较其他因素高。
结论：胎儿中孕期透明隔腔显示率为100%；中孕期透明隔腔的宽径与胎儿双顶径、头围、小脑横径呈低度直线相关；胎儿中孕期透明隔腔的宽径较长径更具有统计学意义
第二部分：中孕期胎儿的透明隔腔消失的超声诊断
目的：探讨中孕期胎儿透明隔腔消失的超声诊断意义。
方法：回顾性分析自2009年1月1日至2011年6月31日在青岛市妇女儿童医院系统产前超声检查中检出的透明隔腔消失的病例,分析其超声特点,合并畸形情况及其妊娠结局。
结果：67例超声筛查胎儿透明隔腔消失,其中胼胝体发育不良31例(46.3%),前脑无裂畸形22例(32.8%),孤立性透明隔腔消失病例14例(20.9%),收集病例的引产后解剖病理结果或引产后标本影像学检查结果。随访至足月分娩仅3例,均为孤立性透明隔腔消失病例,其中最大者随访至2岁1个月,神经学检查均未见明显先天性结构异常。
结论：中孕期超声筛查中出现的胎儿透明隔腔消失病例,应结合孕周连续观察,并注意其与其他中枢神经系统畸形的相关性,对孤立存在的透明隔腔消失应慎重做出畸形诊断。
第三部分：中孕期胎儿的透明隔腔消失的MR I对比诊断
目的：探讨中孕期胎儿透明隔腔消失的MRI诊断意义。
方法：回顾性分析自2009年1月1日至2011年6月31日在青岛市妇女儿童医院系统产前超声检查中检出的透明隔腔消失的病例,进行MRI检查,分析其MRI特点,合并畸形情况及其妊娠结局变化。
结果：67例超声筛查胎儿透明隔腔消失,行MRI检查52例,其中胼胝体发育不良23例(44.2%),前脑无裂畸形20例(38.5%),孤立性透明隔腔消失病例9例(17.3%)。进行引产后病理解剖或标本影像学检查。其中随访显示足月分娩仅3例,均为孤立性透明隔腔消失病例,最大者已2岁1个月,神经学检查均未见明显先天性结构异常。
结论：MRI在透明隔腔的显示效果较超声更精确,可对胎儿颅内是否存在结构异常可以进行准确诊断,可对其分类、预后及产前诊断咨询提供有效帮助。
PART ONE
Prenatal ultrasonography mesurement of cavum septum pellucidum
Objective To measure the cavum septum pellucidum, and evaluate the relationship between BPD,HC and the size of cavum septum pellucidum.
Methods Measure the CSP of300normal fetus was suspected in45pregnant women by prenatal US from January2009to November2010in Qingdao women&children hospital. Prenatal systemic ultrasonography was performed,analysing the findings of prenatal US and MR images and their following-ups.Results22(40%) fetuses were ACC in55pregnant women.20(36.4%) fetuses accompanied with other abnormalities and13(28.9%) fetuses were suspected to isolated absence of CSP.3fetuses were term born, and the oldest one was2.1years old up to now. all these cases are normal.Conclusion The US diagnosis of the absence of CSP should be examined continuously and combined with gest age. The characteristic of US diagnosis in absence of CSP maybe uncertain.
PART TWO
Prenatal ultrasonography analysis of absence of cavum septum pellucidum
Objective To analyse the value of the ultrasonography (US) in the prenatal diagnosis of absence of cavum septum pellucidum (CSP). Methods Fetal absence of CSP was suspected in67pregnant women by prenatal US from January2009to June2011in Qingdao women&children hospital. Prenatal systemic ultrasonography was performed,analysing the findings of prenatal US and MR images and their following-ups.Results31(46.3%) fetuses were ACC in67pregnant women.22(2.8%) fetuses accompanied with other abnormalities and14(20.9%) fetuses were suspected to isolated absence of CSP.3fetuses were term born, and the oldest one was2.1years old up to now. all these cases are normal.Conclusion The US diagnosis of the absence of CSP should be examined continuously and combined with gest age. The characteristic of US diagnosis in absence of CSP maybe uncertain.
PART THREE
Prenatal MRI analysis of absence of cavum septum pellucidum
Objective To analyse the value of the MRI in the prenatal diagnosis of absence of cavum septum pellucidum(CSP). Methods Fetal absence of CSP was suspected in55pregnant women by prenatal US from January2009to November2010in Qingdao women&children hospital. MR images was performed,analysing the findings of MR images and and their following-ups.Results42fetuses were performed MRI in55pregnant women.13ACC(31%) were diagnosed,20(47.6%) fetuses accompanied with other abnormalities and9(21.4%) fetuses were suspected to isolated absence of CSP.3fetuses were term born, and the oldest one was2.1years old up to now. untill now all these cases are normal.Conclusion AS the second choise,the MRI diagnosis of the absence of CSP is more correctable than US. In the diagnosis of CSP absence, MRI should be helpful in clinical diagnosis.
目的：对中孕期胎儿透明隔腔进行超声基础测量,包括中孕期内透明隔腔的正常值范围及透明隔腔与孕周、双顶径、头围、小脑横径间的关系。
材料与方法：对中孕期300例正常胎儿取侧脑室平面显示脑中线的前1/3处、侧脑室前角内一对平行的线性回声之间长方形或三角形的液性暗区即透明隔腔,测量其长径、宽径。3位从事产前诊断工作5年以上、资历相当的超声诊断医生采集图像,显示欠清晰时多次检查至得到满意切面,重复测量三次,取平均值计数。对孕周、双顶径、头围、小脑横径及透明隔腔数据进行统计学分析处理。结果：在300例胎儿中,透明隔腔显示率达100%,但共有256例成功测量了透明隔腔的长径与宽径,测量成功率为85.3%。256例正常胎儿透明隔腔长径测量值为1.23±0.32cm,范围由0.4cm至1.8cm,宽径为0.59±0.10cm,范围0.3cm～0.9cm。本研究中所测量的透明隔腔长径与孕周相关性小,宽径的均值在28w之前逐渐增宽,28周后略有减低。孕期各因素如孕周、双顶径、小脑横径、头围等与透明隔腔的长径、宽径间均呈现较低的相关性,而长径与其他因素的相关性较宽径的相关性更低,其中头围与透明隔腔宽径相关度较其他因素高。
结论：胎儿中孕期透明隔腔显示率为100%；中孕期透明隔腔的宽径与胎儿双顶径、头围、小脑横径呈低度直线相关；胎儿中孕期透明隔腔的宽径较长径更具有统计学意义
第二部分：中孕期胎儿的透明隔腔消失的超声诊断
目的：探讨中孕期胎儿透明隔腔消失的超声诊断意义。
方法：回顾性分析自2009年1月1日至2011年6月31日在青岛市妇女儿童医院系统产前超声检查中检出的透明隔腔消失的病例,分析其超声特点,合并畸形情况及其妊娠结局。
结果：67例超声筛查胎儿透明隔腔消失,其中胼胝体发育不良31例(46.3%),前脑无裂畸形22例(32.8%),孤立性透明隔腔消失病例14例(20.9%),收集病例的引产后解剖病理结果或引产后标本影像学检查结果。随访至足月分娩仅3例,均为孤立性透明隔腔消失病例,其中最大者随访至2岁1个月,神经学检查均未见明显先天性结构异常。
结论：中孕期超声筛查中出现的胎儿透明隔腔消失病例,应结合孕周连续观察,并注意其与其他中枢神经系统畸形的相关性,对孤立存在的透明隔腔消失应慎重做出畸形诊断。
第三部分：中孕期胎儿的透明隔腔消失的MR I对比诊断
目的：探讨中孕期胎儿透明隔腔消失的MRI诊断意义。
方法：回顾性分析自2009年1月1日至2011年6月31日在青岛市妇女儿童医院系统产前超声检查中检出的透明隔腔消失的病例,进行MRI检查,分析其MRI特点,合并畸形情况及其妊娠结局变化。
结果：67例超声筛查胎儿透明隔腔消失,行MRI检查52例,其中胼胝体发育不良23例(44.2%),前脑无裂畸形20例(38.5%),孤立性透明隔腔消失病例9例(17.3%)。进行引产后病理解剖或标本影像学检查。其中随访显示足月分娩仅3例,均为孤立性透明隔腔消失病例,最大者已2岁1个月,神经学检查均未见明显先天性结构异常。
结论：MRI在透明隔腔的显示效果较超声更精确,可对胎儿颅内是否存在结构异常可以进行准确诊断,可对其分类、预后及产前诊断咨询提供有效帮助。
PART ONE
Prenatal ultrasonography mesurement of cavum septum pellucidum
Objective To measure the cavum septum pellucidum, and evaluate the relationship between BPD,HC and the size of cavum septum pellucidum.
Methods Measure the CSP of300normal fetus was suspected in45pregnant women by prenatal US from January2009to November2010in Qingdao women&children hospital. Prenatal systemic ultrasonography was performed,analysing the findings of prenatal US and MR images and their following-ups.Results22(40%) fetuses were ACC in55pregnant women.20(36.4%) fetuses accompanied with other abnormalities and13(28.9%) fetuses were suspected to isolated absence of CSP.3fetuses were term born, and the oldest one was2.1years old up to now. all these cases are normal.Conclusion The US diagnosis of the absence of CSP should be examined continuously and combined with gest age. The characteristic of US diagnosis in absence of CSP maybe uncertain.
PART TWO
Prenatal ultrasonography analysis of absence of cavum septum pellucidum
Objective To analyse the value of the ultrasonography (US) in the prenatal diagnosis of absence of cavum septum pellucidum (CSP). Methods Fetal absence of CSP was suspected in67pregnant women by prenatal US from January2009to June2011in Qingdao women&children hospital. Prenatal systemic ultrasonography was performed,analysing the findings of prenatal US and MR images and their following-ups.Results31(46.3%) fetuses were ACC in67pregnant women.22(2.8%) fetuses accompanied with other abnormalities and14(20.9%) fetuses were suspected to isolated absence of CSP.3fetuses were term born, and the oldest one was2.1years old up to now. all these cases are normal.Conclusion The US diagnosis of the absence of CSP should be examined continuously and combined with gest age. The characteristic of US diagnosis in absence of CSP maybe uncertain.
PART THREE
Prenatal MRI analysis of absence of cavum septum pellucidum
Objective To analyse the value of the MRI in the prenatal diagnosis of absence of cavum septum pellucidum(CSP). Methods Fetal absence of CSP was suspected in55pregnant women by prenatal US from January2009to November2010in Qingdao women&children hospital. MR images was performed,analysing the findings of MR images and and their following-ups.Results42fetuses were performed MRI in55pregnant women.13ACC(31%) were diagnosed,20(47.6%) fetuses accompanied with other abnormalities and9(21.4%) fetuses were suspected to isolated absence of CSP.3fetuses were term born, and the oldest one was2.1years old up to now. untill now all these cases are normal.Conclusion AS the second choise,the MRI diagnosis of the absence of CSP is more correctable than US. In the diagnosis of CSP absence, MRI should be helpful in clinical diagnosis.
引文
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