产前超声提示透明隔腔异常与MRI对比分析  

The Comparison of Prenatal Ultrasound and MRI in the Diagnosis of Abnormal Cavum of Septumpellucidum

作　　者：孙丽娟[1] 高小平[1] 韩吉晶[1] 岳嵩[1] 王新莲[2] 郭翠霞[1] 吴青青[1] Sun Lijuan;Gao Xiaoping;Han Jijing;Yue Song;Wang Xinlian;Guo Cuixia;Wu Qingqing(Department of Ulrasound,Bejing Obstetrics and Gynecology Hospital,Capital Medical University,Bejing 100026,China;Department of Radiology,Bejing Obstetrics and Gynecology Hospital,Capital Medical University,Bejing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院超声科,北京市100026 [2]首都医科大学附属北京妇产医院放射科,北京市100026

出　　处：《中国超声医学杂志》2021年第4期441-445,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨产前超声提示透明隔腔(CSP)异常的临床意义。方法回顾性分析孕期超声提示CSP异常的胎儿声像图,随访MRI检查结果及妊娠结局,进行对比分析。结果43例产前超声提示CSP异常具有MRI结果及妊娠结局。产前超声与MRI诊断相符的有35例,不相符的有2例,MRI对超声诊断提供补充信息的有6例。43例CSP异常具体如下:①CSP未显示15例,其中13例为CSP缺如,包括胼胝体发育异常10例、单纯性CSP缺如1例、叶状全前脑1例、脑积水伴局部中线脑疝1例(获得性CSP缺如),2例CSP存在(超声假阳性);②偏窄21例,胼胝体发育正常19例,2例合并部分型胼胝体缺如;③增宽5例,妊娠结局均良好;④2例形态异常,其中1例为宫内巨细胞病毒感染,另1例为CSP发育异常。结论产前超声是诊断胎儿颅脑异常的重要工具,提示CSP未显示应高度怀疑神经系统异常,并进行鉴别诊断。单纯性CSP偏窄或增宽大多预后良好。MRI是重要的补充检查方式,可进一步确认神经系统畸形类型及补充诊断。Objective To explore the clinical significance of abnormal cavum of septum pellucidum(CSP) by prenatal ultrasound. Methods The prenatal ultrasound images with abnormal CSP were analyzed retrospectively from the pregnant women enrolled in our hospital. The MRI examinations and pregnancy outcome were follow-up. Results Forty-three fetuses had MRI results and pregnant outcomes. The accordance rate of prenatal ultrasound diagnosis with MRI diagnosis was 81.4%(35/43), while 2(2/43,4.7%) cases were inconsistent. Fetal brain MRI could provide additional information for 6 cases(6/43,14.0%). Forty-three cases with abnormal fetal CSP discovered by prenatal ultrasound were as follows:(1) The CSP was unable to be shown in 15 fetuses, including 13 cases with absent CSP(10 with agenesis of corpus callosum, 1 with isolated absence of CSP, 1 with lobar holoprosencephaly, 1 hydrocephaly with local midline hernia) and 2 cases with the presence of CSP(false positive by ultrasound).(2) The width of CSP was narrow in 21 fetuses, including 19 cases with normal corpus callosum and 2 partial agenesis of corpus callosum.(3) The pregnant outcomes for 5 cases with wide CSP were good.(4) Two CSP with abnormal shape included one with intrauterine cytomegalovirus infection and the other one with dysplastic CSP. Conclusions Prenatal ultrasound is an important tool for diagnosing fetal brain malformation. Nervous system anomalies should be highly suspected when CSP can′t be demonstrated by prenatal ultrasound, and differential diagnosis should be performed. The prognosis of cases with isolated narrow or wide CSP were generally good. Fetal brain MRI is a kind of supplementary instrument, which can further confirm the nervous system malformation and provide additional information.

关 键 词：产前超声 透明隔腔 胼胝体 中枢神经系统 MRI 

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