超声与MRI检查胎儿脊髓拴系的对比分析  

Comparative Analysis of Ultrasound and Magnetic Resonance Imaging in Fetal Tethered Cord Examination

作　　者：阮俊贤 何韶铮[2] 施丽景[1] 陈添峰 吕国荣 

机构地区：[1]泉州市儿童医院.妇幼保健院超声科,福建省泉州市362000 [2]福建医科大学附属第二医院超声科 [3]福建省泉州医学高等专科学校

出　　处：《中国超声医学杂志》2017年第11期1006-1009,共4页Chinese Journal of Ultrasound in Medicine

基　　金：福建省自然科学基金项目-卫生联合资金面上项目(No.2015J01447);泉州市技术研究与开发项目计划[No.Z(2012)0116]

摘　　要：目的探讨二维超声及MRI检查胎儿脊髓拴系的价值。方法 346例正常胎儿为正常组,11例产后尸检脊髓拴系的胎儿为拴系组,运用二维超声测量两组胎儿脊髓圆锥末端与最末尾骨远端之间距离(CD),建立不同孕周胎儿CD的正常值范围。随机抽取正常组40例,行MRI检查并测量CD值,进行医师内及医师间测量结果的信度分析,对拴系组胎儿两种检查方法进行对比分析。结果 (1)正常胎儿脊髓CD随孕周增大而增加,超声:CD值(cm)=-0.894+0.198×孕周,R2=0.922;MRI检查:CD值(cm)=-0.901+0.186×孕周,R2=0.886;(P均<0.05);(2)拴系组胎儿CD值均较正常组胎儿缩短;(3)同一医师或不同医师运用两种方法测量CD值的重复性及一致性好,(P均<0.05);(4)二维超声及MRI对拴系组胎儿CD值结果分别为(2.014±0.210)cm及(2.106±0.154)cm,结果t=-1.504,P=0.163。结论超声检测胎儿脊髓拴系准确性与MRI相当。Objective To explore the value of two-dimensional ultrasound and magnetic resonance imaging （MRI） in fetal tethered cord examination. Methods A total of 346 normal fetuses were selected as normal group and 11 fetuses diagnosed as tethered cord in postnatal autopsy were selected as tethered cord group. Conus distance （CD） of fetuses in two groups was measured using two-dimensional ultrasound to establish the normal range of CD in fetuses at different gestationai weeks. A total of 40 cases were randomly selected from the normal group, for whom MRI ex- amination and CD measurement were performed. Intra-doctor and inter-doctor reliability of measurement results were analyzed, and two examinations were compared in fetuses of tethered cord group. Results （1）CD values of normal fe- tuses increased with gestational weeks, ultrasound： CD （cm） = -- 0. 894 ＋ 0. 198 × gestational weeks, R2 = 0. 922 MRI： CD（cm） = --0. 901-1-0. 186Xgestational weeks, R2 =0. 886 （both P〈0.05）. （2）CD values of fetuses in teth- ered cord group were reduced compared with those of fetuses in normal group. （3）CD values measured by the same doctor or different doctors using two examinations had good repeatability and consistency （both P〈0.05）. （4）CD val- ues of fetuses in tethered cord group measured by two-dimensional ultrasound and MRI were （2. 014±0. 210） and （2. 106±0. 154）, respectively （t= - 1. 504, P=0. 163）. Conclusions The accuracy of ultrasound in fetal tethered cord examination is comparable to that of MRI.

关 键 词：二维 超声 MRI 脊髓拴系 胎儿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]