多模式超声在胎儿非严重闭合性脊柱裂筛查中的应用  

Application of multimodal ultrasound in screening of non severe closed spina bifida

作　　者：李江华[1] 周伟娜[1] 马征戈 郑倩颖 张博[1] 顾晔 郑丽雅[1] LI Jianghua;ZHOU Weina;MA Zhengge;ZHENG Qianying;ZHANG Bo;GU Ye;ZHENG Liya(Department of Ultrasound,Baoding First Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院超声科,河北保定071000

出　　处：《分子影像学杂志》2021年第5期853-855,共3页Journal of Molecular Imaging

基　　金：河北省卫生和计划委员会科研基金项目(20191241)。

摘　　要：目的研究多模式超声在胎儿非严重闭合性脊柱裂筛查中的临床应用价值。方法对医院2017年1月~2020年1月接收的多模式超声产前筛查并诊断为胎儿脊柱畸形的19例病例进行总结,分析多模式超声在产前筛查胎儿脊柱畸形中的价值。结果38564例孕妇中共19例被诊断为胎儿脊柱裂,其中产前系统超声共检出18例,超声脊柱裂检出率为0.047%(18/38564),剩余1例因多次产前检查胎儿均为臀位,未获得可用的影像资料而漏诊,漏诊率为5.26%(1/19)。18例经超声检查提示胎儿脊柱裂者均自愿终止妊娠,并经术后尸检证实。19例脊柱裂胎儿中,开放性脊柱裂15例,闭合性脊柱裂4例。其中15例开放脊柱裂者中合并脑积水者6例,足内翻者4例,产前超声检查中有脑室扩张、颅后窝消失、柠檬头征、室间隔缺损等影像征象。4例闭合性脊柱裂均合并脊髓圆锥低位,1例同时合并椎管内脂肪瘤。结论多模式超声检查具有安全、可重复性强等优势,能有效筛查胎儿脊柱裂。Objective To explore the clinical value of multimodal ultrasound in screening for fetal non severe closed spina bifida.Methods We summarized 19 cases of fetal spinal deformity diagnosed by indirect multi-mode ultrasound prenatal screening from January 2017 to January 2020.The value of multi-mode ultrasound in prenatal screening of fetal spinal deformity was analyzed.Results Among the 38564 pregnant women,19 cases were diagnosed as fetal spina bifida,of which 18 cases were detected by prenatal ultrasound.The detection rate of ultrasonic spina bifida was 0.047%(18/38564).The remaining one case was missed diagnosis because the fetus was breech position and no available imaging data was obtained.The missed diagnosis rate was 5.26%(1/19).Eighteen cases of fetal spina bifida were voluntarily terminated pregnancy,and confirmed by autopsy.Among 19 cases of spina bifida,15 cases were open spina bifida and 4 cases were closed spina bifida.Among 15 cases of open spina bifida,6 cases were complicated with hydrocephalus,4 cases were varus.Prenatal ultrasound showed ventricular dilatation,disappearance of posterior cranial fossa,lemon head sign,ventricular septal defect and other imaging signs.Four cases of closed spina bifida were combined with low conus medullaris,and one case was combined with intraspinal lipoma.Conclusion Multimodal ultrasound is safety and repeatability,which can effectively screen fetal spina bifida.

关 键 词：多模式超声 胎儿 脊柱裂 

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]