孕中晚期正常胎儿颈椎长度与胎龄关系的磁共振研究  

MRI evaluation of fetal cervical spine length in normal second and third trimester of pregnancy

作　　者：赵慧[1] 林祥涛[1] 肖连祥[1] 吴勇[1] 董金叶[1] 张忠和[2] 汤煜春[2] 刘树伟[2] 王光彬[1] 

机构地区：[1]山东大学医学院山东省医学影像学研究所,济南250012 [2]山东大学医学院断层影像解剖学研究中心,济南250012

出　　处：《中国临床解剖学杂志》2016年第2期160-164,170,共6页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金(31371213);山东省自然科学基金(ZR2013HM091)

摘　　要：目的研究正常胎儿标本颈椎长度与孕周变化的关系,绘制正常胎儿脊柱长度生长曲线。方法本研究为前瞻性研究,利用3.0T MR扫描仪对65例16～42周自然流产及因母体或胎儿因素引产的胎儿标本行全脊柱3D-T2WI序列扫描,对所得图像进行三方位重建,在正中矢状位上测量颈椎长度及C4椎体的高度,建立相关线性回归方程。结果胎儿颈椎长度及C4椎体高度与孕周的线性回归方程分别为：颈椎长度（cm）=0.193＋0.117孕周,R2=0.94,P〈0.05;C4椎体高度（cm）=0.025＋0.013孕周,R2=0.94,P〈0.05。颈段脊柱发育有着时间的不平衡性,在生长发育过程中有两个发育高峰,分别为23～26孕周及31～34孕周;同样在这两个高峰,椎体高度增长速度较快。结论孕中晚期,胎儿颈椎长度的增加与胎龄呈良好相关性,椎体的相关径线是评估胎儿脊椎发育的可靠指标。Objective Using the magnetic resonance imaging（MRI） to measure the normal fetal cervical spine length at different gestational ages,to investigate a more sensitive nomogram of fetal spine length and gestational ages. Methods This research is a prospective study, Postmortem MR imaging was performed on 65 fetuses ranging from 16 to 42 gestational ages. 3D-T2 WI of the whole spine was performed in sagittal plane and the images were reconstructed in the coronal, sagittal and axial planes to measure the length of the cervical spine segments and the 4th cervical vertebra in the midsagittal images. Liner regression equations were established. Results A statistically significant linear relationship was established between the lengths of cervical segments of the fetal spine and gestational ages, and the function were expressed by the regression as： Cervical length = 0.193 ＋ 0.117 × gestational age,R2=0.94;The C4 height=- 0.586 ＋ 0.155 ×gestational age,R2=0.94. At the same time, the development of the cervical segment and the 4th cervical vertebra is imbalanced. There were two peaks during growth stages,which were 23～26 gestational age and 31～34 weeks, respectively. Conclusions The fetal spine length appears as an easily acquired and valuable parameter,which strongly correlates with gestational age. Therefore it can be used to evaluate gestational age and to assess morphologic maturity of fetuses in the second and third trimester of pregnancy.

关 键 词：胎儿标本 颈椎长度 生长发育 磁共振成像 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学] R322.81[医药卫生—基础医学]