孕11〜13^(+6)周第四脑室扩张胎儿后脑部超声特征研究  

Study On Ultrasound Characteristics of Posterior Brain in Fetuses with Enlargement of Fourth Ventricle At 11-13^(+6) Weeks

作　　者：马莉 周宁 朱永胜 陈秀兰 罗秀霞 陈艳 Ma Li;Zhou Ning;Zhu Yongsheng;Chen Xiulan;Luo Xiuxia;Chen Yan(Department of Ultrasound,Shengzhen Hospital of South Medical University,Shenzhen,Guangdong 518000,China)

机构地区：[1]南方医科大学深圳医院超声科,深圳市518000

出　　处：《中国超声医学杂志》2021年第6期670-673,共4页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市卫生计生委科研项目(No.201601041);深圳市科技计划项目(No.JCYJ20180306174225855)。

摘　　要：目的探讨孕11〜13^(+6)周第四脑室增宽胎儿后脑部超声特征。方法对180例正常胎儿、7例诊断为Dandy-Walker综合症(DWS)胎儿和3例因第四脑室扩张而被诊断为Blake's pouch囊肿(BPC)胎儿的孕11〜13^(+6)周经腹超声图像进行分析和测量。在颅脑正中矢状切面上比较其脑干、第四脑室、后颅窝池等结构的形态特征,测量脑干前后径(BS)、第四脑室宽度(FV)、脑干后缘至枕骨之间的距离(BSOB)。结果180例胎儿的后脑部可见脑干、第四脑室、后颅窝池低回声结构清晰显示,位于几乎平行的四条高回声线之间;DWS胎儿及BPC胎儿第四脑室和后颅窝池之间的分界线显示不清,第四脑室呈囊状扩张,明显增宽,但增宽程度两者无明显差异。正常胎儿BS、FV及BSOB均随头臀长的增加呈线性增加。两组异常胎儿FV均大于正常值第95百分位数,且部分胎儿BS变小,部分胎儿BSOB增大。结论孕11〜13^(+6)周DWS及BPC胎儿后颅窝结构较正常胎儿发生改变,FV值显著增大,可以作为孕11〜13^(+6)周筛查DWS及BPC的指标。Objective To explore the ultrasound characteristics of posterior brain in fetuses with enlargement of fourth ventricle at 11-13+6 weeks.Methods Transabdominal ultrasound images of 180 normal fetuses,7 fetuses diagnosed with Dandy-Walker syndrome(DWS)and 3 cases diagnosed with Blake′s pouch cyst(BPC)fetuses at 11-13+6 weeks′gestation were analyzed and measured.The thickness of brain stem(BS),fourth ventricle(FV),cisterna magna(CM)and brain stem to occipital bone(BSOB)in the mid-sagittal plane of the brain were measured.Results The hypo-echoic structure of BS,FV and CM in 180 fetuses was clearly displayed between four almost paralleled hyper-echoic lines.The dividing lines between FV and CM in fetuses with DWS and BPC were not clear,and FV were dilated significantly,but there was no significant difference between DWS and BPC fetuses.BS,FV and BSOB all increased linearly with the increase in CRL in normal fetuses.FV were greater than the normal value of 95 percentiles in abnormal fetuses of both groups of DWS and BPC.Only part of BS decreased,and part of BSOB increased in abnormal fetuses.Conclusions The morphology of posterior brain in fetuses with DWS and BPC is different from that of normal fetuses at 11-13+6 gestational weeks,and FV increased significantly,which can be used as an index for screening DWS and BPC at 11-13+6 weeks′gestation.

关 键 词：孕11~13+6周 Dandy-Walker综合症 Blake′s囊肿 第四脑室增宽 

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]