孕中晚期胎儿标本颈、胸、腰段脊髓发育的MRI研究  

Development of fetal cervical,thoracic,and lumbar spinal cord in the second and third trimesters based on MRI

作　　者：于新慧 林楠 陈晓丽 田迷迷 肖连祥 张帅 赵慧 林祥涛 Yu Xinhui;Lin Nan;Chen Xiaoli;Tian Mimi;Xiao Lianxiang;Zhang Shuai;Zhao Hui;Lin Xiangtao(Medical Integration and Practice Center,Cheeloo College of Medicine,Shandong University,Jinan 250100,China;Department of Imaging Center,the Third People's Hospital of Jinan,Jinan 250132,China;Department of Imaging Center,Shandong Public Health Clinical Center,Jinan 250102,China;Department of Medical Imaging,Shandong Provincial Hospital,Jinan 250021,China;Department of Radiology,Shandong Maternal and Child Health Hospital,Jinan 250014,China;Department of Imaging,Shandong Second Provincial General Hospital,Jinan 250022,China)

机构地区：[1]山东大学齐鲁医学院医学融合与实践中心,济南250100 [2]济南市第三人民医院影像中心,济南250132 [3]山东省公共卫生临床中心影像中心,济南250102 [4]山东省立医院医学影像科,济南250021 [5]山东省妇幼保健院放射科,济南250014 [6]山东省第二人民医院影像科,济南250022

出　　处：《中华解剖与临床杂志》2024年第9期575-581,共7页Chinese Journal of Anatomy and Clinics

基　　金：山东省自然科学基金(ZR2021MH216)。

摘　　要：目的基于MRI观察孕中晚期胎儿标本颈、胸、腰段脊髓长度随胎龄(孕周)增长的变化及发育规律。方法横断面研究。纳入山东大学断层解剖学研究中心的36例孕中晚期(18~42孕周)脊髓发育正常的胎儿标本为研究对象。使用3.0 T MR扫描仪对所有胎儿标本脊柱行三维双回波稳态进动水激发T2加权像序列扫描。应用RadiAnt软件对图像进行重建,分别测量颈、胸、腰段脊髓长度,以颈、胸、腰3段脊髓长度之和代表脊髓总长度,再分别测量颈椎、胸椎、腰椎长度。观察指标:(1)统计不同孕周胎儿颈、胸、腰各段脊柱长度,以及脊髓的长度、增幅、增长率。(2)计算颈、胸、腰各段脊髓长度占脊髓总长度的比值。(3)对颈、胸、腰各段脊髓长度及脊髓总长度与孕周进行相关性分析。结果(1)所观察孕期内,颈段脊髓和胸段脊髓长度分别较颈椎和胸椎节段略长,腰段脊髓长度比腰椎节段短。颈段脊髓长度在25~28孕周增幅最大、在21~24孕周增长率最大,胸段脊髓长度在41~42孕周增幅最大、在21~24孕周增长率最大,腰段脊髓长度在41~42孕周增幅最大、在25~28孕周增长率最大。(2)在脊髓总长度中,颈段脊髓长度所占比值范围为0.230~0.276,高峰出现在21~28孕周;胸段脊髓长度所占比值范围为0.517~0.573,高峰出现在18~20孕周;腰段脊髓长度所占比值范围为0.177~0.235,高峰出现在41~42孕周。(3)颈、胸、腰各段脊髓长度及脊髓总长度均与孕周呈正相关,线性回归方程:Y^颈段脊髓长度=0.106X孕周+0.417(R2=0.932,P<0.05)、Y^胸段脊髓长度=0.254X孕周+0.027(R2=0.962,P<0.05)、Y^腰段脊髓长度=0.119X孕周-0.541(R2=0.931,P<0.05)、Y^脊髓总长度=0.479X孕周-0.097(R2=0.967,P<0.05)。结论胎儿标本MRI可以清晰显示胎儿脊髓,胎儿颈、胸、腰段脊髓具有各自发育的特异性,均与孕周呈正相关。Objective This study aimed to explore the changes and developmental patterns in the length of cervical,thoracic,and lumbar spinal cord with gestational age in the second and third trimesters of pregnancy based on MRI.Methods A cross-sectional study was conducted.A total of 36 fetal specimens with normal spinal cord development in the second and third trimesters(18-42 weeks of gestation)were included in the study.These specimens were provided by the Sectional Anatomy Research Center of Shandong University.All fetal specimens of the spine were scanned using a 3.0 T MR Scanner with a three-dimensional double-echo steady-state precession water-excitation T2-weighted imaging sequence.RadiAnt software was used to reconstruct the images and measure the lengths of the cervical,thoracic,and lumbar spinal cord.The sum of the lengths of the cervical,thoracic,and lumbar spinal cord represented its total length,and then the lengths of the cervical,thoracic,and lumbar spine were measured.The observation indexes were obtained as follows:(1)The length of the spine of the cervical,thoracic,and lumbar,and the length,growth amplitude and growth rate of the spinal cord of the fetus at different gestatinal week were analyzed.(2)the ratio of the length of each cervical,thoracic,and lumbar segment to the total length of the spinal cord was calculated.(3)The length of the cervical,thoracic,and lumbar spinal cord,the total length of the spinal cord,and gestational age were analyzed by correlation analysis.Results(1)The length of the cervical and thoracic spinal cord was slightly longer than that of the corresponding cervical and thoracic spine segments,respectively,and the length of the lumbar spinal cord was shorter than that of lumbar spine segments.The length of the cervical spinal cord increased the most at 25-28 weeks of gestation,with the highest growth rate at 21-24 weeks of gestation;the length of the thoracic spinal cord increased the most at 41-42 weeks of gestation,with the highest growth rate at 21-24 weeks of gestation;the l

关 键 词：胎儿发育 脊髓 磁共振成像 

分 类 号：R714.5[医药卫生—妇产科学] R445.2[医药卫生—临床医学]