MRI磁敏感加权成像对中晚孕周胎儿椎体骨化中心发育轨迹的研究  

MRI susceptibility weighted imaging for monitoring vertebral development trajectory in second-third trimester fetuses

作　　者：蔡先云 陈欣 王静 魏新红 刘雯 李玉超 侯西蔓 梁蝴蝶 单瑞芹[3] 王光彬 Cai Xianyun;Chen Xin;Wang Jing;Wei Xinhong;Liu Wen;Li Yuchao;Hou Ximan;Liang Hudie;Shan Ruiqin;Wang Guangbin(Department of Radiology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Ultrasound,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Obstetrics,Jinan Maternity and Child Care Hospital,Jinan 250218,China)

机构地区：[1]山东第一医科大学附属省立医院医学影像科,济南250021 [2]山东第一医科大学附属省立医院超声科,济南250021 [3]济南市妇幼保健院山东第一医科大学附属济南妇幼保健院产科,济南250218

出　　处：《中华放射学杂志》2023年第7期777-783,共7页Chinese Journal of Radiology

基　　金：山东省自然科学基金(ZR2020QH268)。

摘　　要：目的利用MRI磁敏感加权成像(SWI)测量中晚孕周胎儿椎体骨化中心形态学参数,探讨椎体的生长发育轨迹。方法前瞻性连续纳入2015年12月至2021年12月山东第一医科大学附属省立医院中晚孕周正常发育的胎儿并行胎儿脊柱SWI扫描。分析胎儿椎体骨化中心影像表现并测量第4颈椎(C4)、第6胸椎(T6)、第3腰椎(L3)、第1骶椎(S1)椎体骨化中心的矢状径、横径、高度、横截面积,计算体积。利用线性或非线性回归分析法确立回归方程并拟合生长轨迹曲线。结果112例胎儿纳入本研究,均为单胎,孕周21~39(29.4±3.9)周。其中,包含C4椎体骨化中心30例,T658例,L392例,S162例。SWI显示宫内胎儿脊柱整体曲度后凸,呈现2个原发性弯曲(胸椎和骶椎后凸)。C4椎体骨化中心的形态学参数矢状径、横径、高度、面积和体积在孕25~38周期间生长轨迹遵循二次多项式规律(R^(2)=0.938、0.943、0.952、0.957、0.982);T6椎体骨化中心的矢状径、横径、高度在妊娠21~38周期间生长轨迹遵循指数生长规律(R^(2)=0.915、0.923、0.849),面积和体积增长遵循二次多项式生长规律(R^(2)=0.943、0.961);L3椎体骨化中心的形态学参数在妊娠21~39周期间生长轨迹遵循二次多项式规律(R^(2)=0.910、0.916、0.914、0.942、0.948);S1椎体骨化中心矢状径、横径、高度在妊娠23~39周期间遵循线性生长规律(R^(2)=0.905、0.911、0.922),面积和体积遵循二次多项式生长规律(R^(2)=0.930、0.964)。结论孕中晚期,胎儿C4、T6、L3、S1椎体骨化中心的生长发育与孕周呈良好的相关性,胎儿椎体骨化中心前期增长缓慢,而随着孕周的增长,椎体的生长速度加快。Objective To measure the morphological parameters of the fetal vertebral centrum ossification centers(COC)in the second-third trimester using MRI susceptibility weighted imaging(SWI),and to explore the growth and development trajectory of the vertebrae.Methods Fetus in the second-third trimester with normal vertebrae development were prospectively and continuously included in Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2015 to December 2021,and the SWI scanning of fetal spine was performed.The following morphometric parameters of the C4,T6,L3,S1 vertebrae COC were measured,including sagittal diameter,transverse diameter,height,cross-sectional area and volume.The linear and nonlinear regression analysis was used to derive the best-fit curve for each parameters and gestational age.Results A total of 112 fetuses were recruited with gestatonal age 21-39(29.4±3.9)weeks,including 30 cases of C4,58 cases of T6,92 cases of L3,62 cases of S1.Fetal spine in utero with global curvature was kyphosis,presenting two primary curves(thoracic and sacral kyphosis).The morphological parameters sagittal diameter,transverse diameter,height,cross-sectional area and volume of C4 followed the quadratic polynomial rule during 25 to 38 weeks(R^(2)=0.938,0.943,0.952,0.957,0.982).During 21 to 38 weeks,the sagittal diameter,transverse diameter and height of the T6 followed the exponential growth pattern(R^(2)=0.915,0.923,0.849)and the growth of the area and volume followed the quadratic polynomial growth pattern(R^(2)=0.943,0.961).The L3 followed the quadratic polynomial rule during 21 to 39 weeks(R^(2)=0.910,0.916,0.914,0.942,0.948)The sagittal diameter,transverse diameter and height of the S1 followed the linear growth pattern(R^(2)=0.905,0.911,0.922)and the area and volume followed the quadratic polynomial growth pattern(R^(2)=0.930,0.964)during 23 to 39 weeks.Conclusions The growth and development of C4,T6,L3 and S1 COC of fetus in the second-third trimester has a good correlation with gest

关 键 词：胎儿 磁共振成像 磁敏感加权序列 椎体 骨化中心 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]