脊柱尾侧椎体超声计数法判定胎儿脊髓圆锥末端位置的临床价值  

Clinical value of ultrasonic caudal vertebral counting method in determining terminal position of fetal conus medullaris

作　　者：黄祝兰 徐金毛 李晓云[1] 陈金凤[1] HUANG Zhu-lan;XU Jin-mao;LI Xiao-yun;CHEN Jin-feng(Department of Ultrasound Medicine,Longgang District Maternal and Child Healthcare Hospital of Shenzhen,Shenzhen 518172,Guangdong,China)

机构地区：[1]深圳市龙岗区妇幼保健院超声医学科,广东深圳518172

出　　处：《生物医学工程与临床》2022年第6期706-710,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的总结脊柱尾侧椎体计数法(CVCM)判定胎儿脊髓圆锥末端(CMT)位置的临床意义。方法选择2019年3月至2021年3月行产前超声检查的103例单胎妊娠孕妇,年龄21~38岁,平均年龄30.85岁;孕周22~37周,平均孕周30.27周。均给予超声脊柱CVCM和腰骶角椎体定位法(LSaLM)检测,对比两种方式在判断胎儿CMT位置方面的差异,比较两者之间的相关性。结果经LSaLM检查103例正常胎儿中,CMT位置最低值2.50,对应L_(3)~L_(4)中点,占2.91%;CMT最高位置值4.25,在L_(1)~L_(2)中下点,占1.94%,CMT位置占比最高值为3.75,对应L_(2)~L_(3)中上点,占30.10%;经CVCM检查103例正常胎儿中尾侧椎体数最少为6.50个,对应第6~7个椎体中点,占2.91%;尾侧椎体数最多为9.25个,对应第9个椎体中下点,占1.94%;占比最高的尾侧椎体数为8~9个椎体中上点,占30.10%,与LSaLM检查中L_(2)~L_(3)中上点位置相对应。26周及以后的胎儿其尾侧椎体数直接在其CMT位置上加5,胎儿孕周的大小与CMT位置之间呈正相关性(r=0.975,P<0.05);孕周大小与尾侧椎体数之间同样呈正相关性(r=0.987,P<0.05),并且CMT位置与尾侧椎体数之间也同样呈正相关性(r=0.980,P<0.05)。结论LSaLM和CVCM检测均可用于判断胎儿CMT位置是否正常,两者之间有着明显的相关性,但后者相较于前者而言在操作方面更加简单快捷,对胎儿体位要求较低,临床应用优势更加显著。Objective To summarize the clinical significance of caudal vertebral counting method(CVCM)in determining the position of fetal conus medullaris terminus(CMT).Methods From March 2019 to March 2021,103 cases of singleton pregnancy were enrolled,which aged 21-38 years old with mean age of 30.85 years old,gestation 22-37 weeks and mean gestational 30.27 weeks.All of them performed ultrasound CVCM and location lumbosacral angular vertebra method(LSaLM),the differences between 2 methods in determining fetal CMT position were compared,and correlation between 2 methods were further compared.Results Among 103 normal fetuses examined by LSaLM,the lowest value of CMT position was 2.50,corresponding to the midpoint of L_(3)~L_(4),accounted for 2.91%.The highest value of CMT was 4.25,corresponding to the lowermiddle point of L_(1)-L_(2),accounted for 1.94%;the highest proportion of CMT position was 3.75,corresponding to the uppermiddle point of L_(2)~L_(3),accounted for 30.10%.The minimum number of caudal vertebrae in 103 normal fetuses examined by CVCM was 6.5,corresponding to the midpoint of the 6th-7th vertebrae,accounted for 2.91%;the maximum number of caudal vertebrae was 9.25,corresponding to lower-middle point of the 9th vertebrae,accounted for 1.94%.The number of caudal vertebrae with the highest proportion was 8-9 vertebral mid-upper points,accounted for 30.10%,which corresponding to the position of L_(2)~L_(3)mid-upper point in LSaLM.The number of caudal vertebrae of the fetus at 26-week or later was directly increased by 5 to CMT position,and there was positive correlation between gestational age of fetus and CMT position(r=0.975,P<0.05).Results further indicated that number of caudal vertebrae had positive correlation with gestational age(r=0.987,P<0.05),and CMT position(r=0.980,P<0.05).Conclusion It is demonstrated that LSaLM and CVCM can be used to determine fetal CMT position is normal or abnormal,and two methods have significant correlation.Compared with LSaLM,CVCM is simpler and faster,with lower requirements

关 键 词：胎儿 脊髓圆锥末端位置 超声检查 脊柱尾侧椎体计数法 腰骶角椎体定位法 

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]