超声检查和MRI在产前诊断胎儿Dandy-Walker变异型中的对比研究  

Comparative study of ultrasonography and MRI in prenatal diagnosis of foetus with Dandy-Walker variant

作　　者：任泉霖[1] 杨太珠[1] 罗红[1] 李昌宪[2] 杨帆[1] 

机构地区：[1]四川大学华西第二医院超声科,成都610041 [2]四川大学华西第二医院放射科,成都610041

出　　处：《中华妇幼临床医学杂志（电子版）》2015年第2期55-58,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：四川省科技厅软科学项目(2012ZROO13)~~

摘　　要：目的回顾性分析胎儿头颅超声检查(US)和MRI在产前诊断胎儿Dandy-Walker变异型(DWV)中的应用价值。方法选择2011年1月至2013年9月在四川大学华西第二医院经胎儿头颅US疑诊为胎儿DWV的11例胎儿为研究对象,并同时对其进行头颅MRI检查。对疑诊为胎儿DWV者随访至引产后或生后1年,以引产后胎儿的尸检结果或随访1年后对患儿再次进行头颅MRI检查结果及其临床表现作为诊断DWV的金标准,并统计学比较胎儿头颅US及MRI产前诊断该病的正确率。本研究遵循的程序符合四川大学华西第二医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象监护人知情同意,并与之签署临床研究知情同意书。结果经头颅US疑诊为胎儿DWV的11例胎儿,同时进行头颅MRI检查结果为:正常胎儿为6例,诊断为胎儿DWV为5例。根据胎儿DWV诊断的金标准,胎儿头颅MRI对胎儿DWV的产前诊断正确率显著高于头颅US,且差异有统计学意义(100.0%vs45.4%,P=0.012)。结论胎儿头颅US是产前诊断胎儿中枢神经系统疾病的首选方法。对US疑诊为胎儿DWV者进一步采取头颅MRI检查确诊,是临床诊断胎儿DWV的必要补充。Objective Retrospective analysis of the prenatal diagnosis values of fetal head ultrasonography（US） and MRI in fetal Dandy-Walker variant （DWV）. Methods A total of 11 fetus suspected diagnosis as fetal DWV prenatal by fetal head US in West China Second University Hospital, Sichuan University from January 2011 to September 2013 were chosen as study subjects,at the same time, they were underwent fetal head MRI in same hospital. All of those fetuses were followed up until induced labor or 1-year after born. The DWV diagnose gold standard is autopsy results of fetus after induction or brain MRI results of suspected diagnosis as fetal DWV cases and clinical manifestations after 1-year follow- up. The accurate rates of prenatal diagnosis of fetal head US and MRI for fetal DWV were analyzed statistically. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital, Sichuan University. Informed consent was obtained from the parents of each participant. Results Among these 11 cases who were suspected diagnosis as fetal DWV prenatal by fetal head US,while the fetal head MRI results were 6 cases of normal fetus,and 5 cases were diagnosed as fetal DWV. According to the gold standard for diagnosis of fetal DWV, the diagnostic accurate rate of fetal head MRI was higher than that of fetal head US,and the difference was significant（100.0% vs 45.4%,P=0. 012）. Conclusions Prenatal diagnosis by fetal head US is the preferred method for fetal central nervous system diseases. When fetal DWV were suspected diagnosis by fetal head US,fetal head MRI is a necessary complement examination for final diagnosis of fetal DWV.

关 键 词：超声检查 磁共振成像 中枢神经系统 Dandy-Walker变异型 产前诊断 

分 类 号：R714.5[医药卫生—妇产科学] R445[医药卫生—临床医学]