胎儿先天性脊柱裂的产前超声诊断及其预后评估研究  

Prenatal Ultrasonic Diagnosis and Evaluation of the Prognosis of Fetal Congenital Spina Bifida

作　　者：张蒂荣[1] 石宇[1] 胡海云[1] 杨晓东[1] 薛敏[1] 王玥[1] 葛喜凤 陈然[1] 

机构地区：[1]北京大学深圳医院超声科,广东深圳518036

出　　处：《中国产前诊断杂志（电子版）》2015年第3期14-18,共5页Chinese Journal of Prenatal Diagnosis(Electronic Version)

基　　金：广东省自然科学基金(S2013010011538)

摘　　要：目的探讨产前超声诊断胎儿先天性脊柱裂及其预后评估的临床价值。方法回顾分析产前超声诊断胎儿脊膜膨出6例、脊髓脊膜膨出16例、脊髓外翻3例、隐性脊柱裂9例及30例正常胎儿脊柱的相关超声资料,总结其声图像特征,并与产后超声、MRI或尸检结果对照。结果 1脊膜膨出声像为:a.背部包块:均见囊性包块向外膨出;b.脊髓圆锥位置:均正常;c.后颅窝池:均正常存在。2脊髓脊膜膨出:a.背部包块:均见混合囊性包块向外膨出;b.脊髓圆锥位置:腰骶部脊柱裂均显示圆锥低位,颈部脊柱裂显示圆锥位置正常;c.后颅窝池:14例消失,2例明显变小。3脊髓外翻声像为:a.背部包块:均未显示包块外膨;b.脊髓圆锥位置:均显示圆锥低位;c.后颅窝池:均消失。4隐性脊柱裂声像为:a.背部包块:均未显示包块外膨;b.脊髓圆锥位置:均显示圆锥低位;c.后颅窝池:均正常存在。5预后:脊髓圆锥低位和后颅窝池消失提示脊柱裂预后不良。结论产前超声能为胎儿先天性脊柱裂的产前诊断及预后评估提供有价值的信息。Objective To evaluate clinical value of the congenital spina bifidu in fetus with ultrasonic im- aging. Method 6 cases with fetal meningocele,16 cases with fetal myelomeningocele,3 cases with fetal meloschisis,9 cases with fetal spina bifida oceulta and 30 cases with normal fetus underwent ultrasonic im- aging. Their final diagnosis were followed up. Results （D In the group of fetus with meningocele, the cystic masses of the back were always shown, but the position of eonus medullaris and the wideth of poste- rior cranial fossa always shown normal^QIn the group of fetus with myelomeningocele, the complex mas- ses of the back were always shown, low conus medullaris were always shown beyond neck myelomeningo- cele, and the width of posterior cranial fossa could not be shown or were shown obviously decreased; @In the group of fetus with meloschisis, the masses of the back and posterior cranial fossa always could not be shown, but low conus medullaris were always shown ~ @In the group of fetus with spina bifida occulta, the masses of the back always could not be shown, but low conus medullaris were always shown, and the width of posterior cranial fossa always shown normal. Conclusions Prenatal ultrasonic imaging can show fetal spina bifidu,and is very useful in evaluation of the prognosis of fetal spina bifidu.

关 键 词：产前 脊柱裂 脊髓圆锥 后颅窝池 预后 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]