三维超声对监测中晚孕期胎儿小脑延髓池的临床意义的探讨  

Clinical significance of three dimensional ultrasonography in monitoring the late pregnancy fetal cerebellomedullary cistern

作　　者：周雷平[1] 牛建梅[1] 

机构地区：[1]上海交通大学附属国际和平妇幼保健院,上海200030

出　　处：《中国妇幼保健》2015年第19期3300-3302,共3页Maternal and Child Health Care of China

基　　金：2008年中国福利会课题<二维和三维超声对胎儿掌骨的初步研究>;2005年上海市长宁区卫生局课题<染色体异常的产前超声检查评估>

摘　　要：目的：分析三维超声检查对中晚孕胎儿小脑延髓池的评价意义。方法：选择1890例中晚孕期产妇为研究对象，均接受三维超声检查，测量小脑延髓池宽度，以8mm、10mm为界，观察小脑延髓池〈8mm、8nm～及≥10mm胎儿产后随访情况。结果：1890例胎儿中，小脑延髓池宽度〈8mm共1421例，8mm～共439例，≥10mm者30例。在≥10mm胎儿中，单纯性小脑延髓池扩张25例，非单纯性小脑延髓池扩张5例，包括后颅凹蛛网膜囊肿4例，Dandy—Walker综合征1例。小脑延髓池宽度在19—33周逐渐增宽，29—33周最宽，而后逐渐变窄。经相关性检验，小脑延髓池宽度与胎儿孕周具有相关性（r=0．928，P〈0．05）。产后随访显示，小脑延髓池宽度≥10mm者异常的比例为53．33％，显著高于小脑延髓池宽度〈8mm及8mm～者异常的比例，差异有统计学意义（P〈0．05）。结论：三维超声检查可以清晰显示中晚孕胎儿小脑延髓池结构，通过对其径线的测量，可以评估胎儿预后。Objective： To investigate the clinical significance of three dimensional ultrasonography in monitoring the late pregnancy fetal cerebcllomedullary cistern. Methods： 1 890 cases of late pregnancy women were selected as the object of study, all of them received three dimensional ultrasonography. The width of cerebellomeduUary cistern was measured. With 8 mm, 10 mm bounded, eerebellomedul- lary cistern 〈8.0 ram, 8 - 10 mm and t〉10 mm fetal postpartum follow-up were observed. Results： In 1 890 cases of fetus, there were 1 421 cases Cistema width 〈8.0 mm, 439 cases of 8 - 10 ram, 30 cases≥10 ram. In≥10 mm fetus, there were 25 cases simple cisterna dil- atation, 5 cases non simple eisterna dilatation, including 4 cases posterior fossa arachnoid cyst, 1 cases Dandy-walker syndrome. Cisterna magna width gradually widened in 19-29 weeks, it was most wide in 29 - 33 weeks, and then gradually narrowing. Through the test of corre- lation, there were correlation between cisterna magna in width and fetal gestational weeks （r = 0. 928, P〈0. 05 ） . Postpartum follow-up showed that the abnormal ratio of Cisterna width ≥ 10 mm was 53.3%, which was significantly higher than that of the eerebellomedullary cis- tern width 〈8.0 mm and 8 - 10 mm abnormal ratio 1.5% and 4. 3% （ P〈0. 05 ） . Large motor score of cisterna width≥ 10 mm was lower than that of 8 - 10 mm and 〈8 mm （P〈0.05） . Conclusion： 3D uhrasonography could clearly show the mid and late gestation fetal cerebel- lomedullary cistern structure, measuring its diameter could evaluate the prognosis of fetus.

关 键 词：三维超声 中晚孕 小脑延髓池 畸形 胎儿 

分 类 号：R445.1[医药卫生—影像医学与核医学]