胎儿终丝囊肿的产前超声检出情况及预后:68例分析  

Prenatal ultrasound detection and prognosis in fetuses with cysts of filum terminale:an analysis of 68 cases

作　　者：李洁[1] 张洁[1] 吴文培 常明兰 栗河舟[1] 朱功升[2] 张灵洁 Li Jie;Zhang Jie;Wu Wenpei;Chang Minglan;Li Hezhou;Zhu Gongsheng;Zhang Lingjie(Department of Ultrasound Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou450052,China;Department of Medical Imaging,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou450052,China)

机构地区：[1]郑州大学第三附属医院超声医学科,郑州450052 [2]郑州大学第三附属医院医学影像科,郑州450052

出　　处：《中华围产医学杂志》2024年第11期932-936,共5页Chinese Journal of Perinatal Medicine

摘　　要：目的探讨胎儿终丝囊肿的产前超声检出情况及预后。方法回顾性分析2020年1月至2023年6月于郑州大学第三附属医院接受Ⅲ级系统超声检查且成功随访的68例胎儿终丝囊肿病例的资料,总结首次检出时间、囊肿大小、伴发异常、宫内是否消失、结局及生后随访情况等。对数据资料进行描述性统计分析。结果终丝囊肿超声最早检出时间为孕21周+4,首次检出时囊肿中位长径为4.3 mm(范围2.0~19.5 mm)。68例中,69%(47/68)为孤立性终丝囊肿,31%(21/68)为非孤立性终丝囊肿。非孤立性终丝囊肿病例伴发结构异常以心血管(7/21,33%)、泌尿生殖(6/21,29%)及神经系统(6/21,29%)多见。41例接受产前超声复查,宫内终丝囊肿消失率为63%(26/41),孤立性与非孤立性终丝囊肿宫内消失率分别为67%(22/33)和4/8。最早消失时间为孕25周,最短持续时间为12 d。10例进行产前遗传学检测的胎儿均未检出明确致病性变异。10例引产,其中2例为孤立性终丝囊肿,8例为非孤立性终丝囊肿。另58例活产分娩,生后随访至3月~3岁,均未出现异常表现。结论胎儿终丝囊肿大多为孤立性,多数可于宫内自行消失,预后较好。ObjectiveTo investigate the prenatal ultrasound detection and prognosis of fetuses with cysts of filum terminale.MethodsA retrospective analysis was conducted on 68 fetuses with cysts of filum terminale that underwent levelⅢsystematic ultrasound examination and were successfully followed up at the Third Affiliated Hospital of Zhengzhou University from January 2020 to June 2023.The analysis included the initial detection time,cyst size,accompanying abnormalities,whether the cysts disappeared in utero,outcomes,and postnatal follow-up.Descriptive statistical analysis was performed.ResultsThe earliest ultrasound detection of filum terminale cysts was at 21 weeks and 4 days of gestation,with a median length of 4.3 mm(range 2.0-19.5 mm).Among the 68 cases,69%(47/68)were isolated filum terminale cysts,and 31%(21/68)were non-isolated filum terminale cysts.Structural abnormalities associated with non-isolated filum terminale cysts were most commonly cardiovascular(7/21,33%),urogenital(6/21,29%),and neurological(6/21,29%)systems.Prenatal ultrasound follow-up was performed in 41 cases,with an intrauterine disappearance rate of 63%(26/41).The disappearance rates for isolated and non-isolated filum terminale cysts were 67%(22/33)and 4/8,respectively.The earliest disappearance was at 25 weeks of gestation,with the shortest duration being 12 days.Prenatal genetic testing was conducted in 10 cases,with no definite pathogenic variants detected.There were 10 cases of induced labor,including two cases of isolated filum terminale cysts and eight cases of non-isolated filum terminale cysts.The remaining 58 cases resulted in live births,with postnatal follow-up ranging from 3 months to 3 years,showing no abnormal findings.ConclusionMost fetal cysts of filum terminale are isolated and can spontaneously disappear in utero,with a generally good prognosis.

关 键 词：超声 终丝囊肿 终丝 脊髓圆锥 胎儿 

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]