超声定位中晚孕期胎儿脊髓圆锥位置的新方法探讨  

The new ultrasonic localization of fetal conus medullaris in the second and third trimester

作　　者：杨硕[1] 宋鑫[1] 张文君[2] 刘静华[3] 吴昀[1] 

机构地区：[1]太和医院妇产中心超声室,湖北442000 [2]太和医院妇产中心超声波科,湖北442000 [3]深圳市龙岗区妇幼保健院超声科,广东518172

出　　处：《放射学实践》2016年第2期183-186,共4页Radiologic Practice

基　　金：深圳市龙岗区科技计划项目(YLWS20140609153851049)

摘　　要：目的：探索中晚孕期胎儿脊髓圆锥（CM）末端至骶尾部最后一个骨化中心的距离段（CS）内包含完整椎体个数的大致规律。方法：采用二维超声成像及表面三维成像计数19~37孕周胎儿CS段内包含完整椎体的个数,然后采用3D容积存储系统存图、4D View软件离线分析,用Kappa检验二维超声与三维超声在计数CS段内完整椎体个数的结果的一致性。结果：546例中253例二维超声成像与三维表面成像计数的完整椎体个数分布一致性极好（k=1.0）。20孕周后CS段内包含完整椎体≥6个,27孕周后均≥7个,34孕周后均≥8个。结论：本研究初步获得了19~37周胎儿各孕周CS段内包含完整椎体个数的参考值范围。三维表面成像可与二维超声相结合来辅助判断胎儿CM位置。Objective：To research a general rule by which the number of complete vertebrae from the end of conus medullaris to the last sacrococcygeal ossification center（Conus-Sacrum,CS）in the second and third trimester can be determined.Methods：The number of complete vertebrae of CS in 19~37weeks can be counted by using two-dimensional ultrasonic imaging and three-dimensional ultrasonic surface imaging,then three-dimensional volume data were collected,4Dview post-processing software was offline analyzed,and Kappa test was used to test the consistency of the number of complete vertebrae in CS section by two-dimensional imaging and three-dimensional imaging.Finally,the distribution of the number of complete vertbrae in CS section in every gestational age was observed.Results：Among 546 cases,253cases were proved to have an excellent consistency in the number of complete vertebrae in CS section by two-dimensional imaging and three-dimensional surface imaging（k=1.0）.There were at least 6complete vertebrae in CS section after 20 weeks of gestation,at least 7complete vertebrae in CS section after 27 weeks of gestation and at least 8complete vertebrae in CS section after 34 weeks of gestation.Conclusion：The related reference ranges of the number of complete vertebrae of CS in 19~37 weeks were preliminary obtained.Three-dimensional surface imaging and three-dimensional VCI technology can be both combined with two-dimensional imaging to accurately determine the location of fetal conus medullaris.

关 键 词：超声检查 胎儿 脊髓圆锥 

分 类 号：R445.1[医药卫生—影像医学与核医学]