中孕期超声筛查胎儿颅内结构异常的横断面调查  

A cross-sectional study based on ultrasound screening of fetal intracranial abnormalities during the second trimester

作　　者：陈观豪 肖喜荣 陶祥 任芸芸 符忠蓬 CHEN Guanhao;XIAO Xirong;TAO Xiang;REN Yunyun;FU Zhongpeng(Department of Obstetrics and Gynecology,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200001,China;Department of Obstetrics,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200001,China;Department of Pathology,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200001,China;Department of Ultrasound,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200001,China)

机构地区：[1]复旦大学附属妇产科医院妇产科,上海200001 [2]复旦大学附属妇产科医院产科,上海200001 [3]复旦大学附属妇产科医院病理科,上海200001 [4]复旦大学附属妇产科医院超声科,上海200001

出　　处：《肿瘤影像学》2022年第3期330-334,共5页Oncoradiology

摘　　要：目的:探讨超声标准化切面检查对中孕期胎儿颅内结构异常的诊断价值。方法:从2014年4月—2017年3月于复旦大学附属妇产科医院行超声标准化颅内畸形筛查的28 465名中孕期孕妇中,筛选出261例神经系统结构异常的胎儿,收集胎儿的产检信息资料。依据孕期胎儿神经系统结构异常的种类进行分组,探讨超声标准化切面检查对中孕期胎儿颅内结构异常的诊断价值。结果:0.92%(261/28 465)经侧脑室及经小脑切面检出颅内结构异常,其中最常见的3种结构异常为侧脑室增宽(41.4%,108/261),脉络膜囊肿(30.3%,79/261),小脑延髓池增宽(21.1%,55/261)。其余是颅内多发异常9例,颅内占位性病变4例,第四脑室孔闭塞综合征(Dandy-Walker综合征)2例,胼胝体发育不全2例,小脑异常1例,小脑扁桃体下疝畸形(Arnold-Chiari)Ⅱ型1例。50例孕妇在中孕期筛查后进一步接受了磁共振成像(magnetic resonance imaging,MRI)检查,有3例结果不完全一致。结论:中孕期标准化切面胎儿神经系统筛查对胎儿颅内结构异常的诊断准确度高,仅对少数胼胝体发育不全、Dandy-Walker综合征、颅内占位性病变等胎儿畸形的精确诊断需要MRI的帮助。Objective: To investigate the diagnostic value of standardized ultrasonography in fetal intracranial structure abnormality during the second trimester. Methods: From the 28 465 pregnant women who underwent ultrasound standardized screening for intracranial malformations during second pregnancy in Obstetrics and Gynecology Hospital Affiliated to Fudan University from April 2014 to March 2017, 261 fetuses with abnormal nervous system structure were screened out, and the prenatal examination information and pregnancy outcome data of the fetuses were collected. According to the types of fetal nervous system malformations during pregnancy, the composition ratio of fetal malformations in each group was analyzed,to evaluate the diagnostic value of ultrasonography standard planes in fetal intracranial structure abnormality in second trimester. Results: A total of 261 cases of intracranial structure abnormality(0.92%, 261/28 465) were detected by ultrasonography through transventricle and transcerebellar plane, the three most common intracranial abnormalities were ventirculomegaly(41.4%, 108/261), choroid plexus cyst(30.3%, 79/261), and mega-cisterna magna(21.1%, 55/261). The rest were 9 cases of multiple intracranial abnormalities, 4 cases of intracranial space occupying lesions, 2 cases of Dandy-Walker syndrome, 2 cases of agenesisi of the corpus callosum, 1 case of cerebellar abnormalities, and 1 case of Arnold-Chiari Ⅱ. Fifty pregnant women underwent further magnetic resonance imaging(MRI) examination after screening during the second trimester, and the results of 3 cases were not completely consistent. Conclusion: The diagnostic accuracy of screening abnormal intracranial structure in the second trimester is high through standard plane, and only the diagnosis of fetal malformations such as agenesisi of the corpus callosum, Dandy-Walker syndrome and intracranial space occupying requires the help of MRI. Ultrasound screening can provide important information for clinical consultation and genetic consultation.

关 键 词：颅内结构异常 超声 中孕期 

分 类 号：R445.1[医药卫生—影像医学与核医学]