中晚孕期胎儿脊髓圆锥位置的超声定位研究  

Study of ultrasonography in localizing fetal conus medullaris in the second and third trimester

作　　者：刘静华[1] 杨硕[2] 蒋莹[1] 徐金毛 宋金爽 刘丽[1] 

机构地区：[1]深圳市龙岗区妇幼保健院超声科,518172 [2]湖北省十堰市太和医院

出　　处：《临床超声医学杂志》2016年第3期157-160,共4页Journal of Clinical Ultrasound in Medicine

基　　金：深圳市龙岗区科技计划项目(20140609153851049)

摘　　要：目的通过超声识别椎体以定位中晚孕期胎儿脊髓圆锥的位置,探讨胎儿期脊髓圆锥大致上升规律。方法选取2014年1～12月在我院门诊接受常规超声检查的正常孕19～37周单胎胎儿566例,应用二维超声识别胎儿椎体,其中296例孕19～28周胎儿同时行表面三维成像和容积对比成像两种三维超声技术,计数脊髓圆锥末端水平所对应腰椎椎体的位置。Kappa检验分析二维与三维超声成像定位脊髓圆锥位置的一致性。观察胎儿脊髓圆锥位置上升趋势,分析各孕周间脊髓圆锥位置的差异性;一元线性相关回归分析脊髓圆锥位置与孕周的关系。结果最终546例二维超声成像可清楚显示脊髓圆锥位置,其中280例孕19～28周胎儿同时获取了三维脊髓圆锥位置图像。二维与两种三维超声成像识别脊髓圆锥位置水平的一致性极好（Kappa值=1.0）。脊髓圆锥位置在孕19周时可位于L3.5甚至是L4,自孕21周开始至整个孕期95%的胎儿脊髓圆锥置均位于L3.5或者L3.5以上,孕28周之后95%的胎儿脊髓圆锥位置达到L3水平,孕37周之后95%的胎儿脊髓圆锥位置均位于L1～L2。脊髓圆锥位置与孕周之间的线性回归方程为：Y=0.098X＋6.113（R=0.722,P〈0.01）。结论超声可清楚显示胎儿脊髓圆锥的位置和形态;通过识别椎体定位胎儿脊髓圆锥的位置,可初步获取其参考值范围。表面三维成像及容积对比成像技术均可与二维超声联合应用以准确判断胎儿脊髓圆锥位置。Objective To discuss the ascending law of fetal conus medullaris through locating the position of fetal conus medullaris in the second and third trimester by ultrasonic identification of centrum.Methods Five hundred and sixty-six cases with normal singleton fetus in our hospital from January to December in 2014 were enrolled and located fetal centrum by two-dimensional ultrasound.And 296 cases in 19～28 gestational weeks were also evaluated by three-dimensional surface imaging and three-dimensional volume contrast imaging（VCI）technology. The level of fetal conus medullaris corresponding to the location of lumbar vertebrae was determined. The consistency of the results of the level of fetal conus medullaris corresponding to the location of lumbar vertebra by two-dimensional imaging and three-dimensional imaging was analyzed with Kappa test. The ascending trend of the location of fetal conus medullaris was observed,and the differences of that among gestational weeks were analyzed.The relation between the location of conus meddullans and fetal gestational age by a linear regression relation was analyzed.Results Five hundred and forty-six cases with two-dimensional imaging showed the location of conus medullaris clearly.280 cases had been proved to be an excellent consistency in the level of conus medullaris by two-dimensional imaging and two kinds of three-dimensional imaging（K = 1. 0）. The location of conus medullaris was in L3.5 and L4 at 19 gestational weeks,95%cases were located in L3.5 or higher than L3.5 at 21 gestational weeks,95% cases were in the level of L3 at 28 gestational weeks,95% cases located in between L1 and L2 after 37 gestational weeks. The linear regression equation between conus medullaris＇ location and gestational age was Y=0.098X＋6.113（R=0.722,P〈0.01）.Conclusion The location and morphology of fetal conus medullaris can be observed clearly by ultrasound.The evaluate of conus medullaris uses three kinds of ultrasonics methods in our study,and related reference ranges are prel

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]