孕中晚期正常发育胎儿眼球的MRI研究  

MRI study of normally developing fetal eyeball development in the second and third trimesters

作　　者：徐理敏 张国福 沈敏花 XU Li-min;ZHANG Guo-fu;SHEN Min-hua(Department of Ultrasound,Lishui People’s Hospital,Lishui 323050,Zhejiang Province,China;Department of Radiology,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200090,China)

机构地区：[1]丽水市人民医院超声科,丽水323050 [2]复旦大学附属妇产科医院放射科,上海200090

出　　处：《复旦学报（医学版）》2024年第6期931-938,共8页Fudan University Journal of Medical Sciences

摘　　要：目的分析孕中晚期正常发育胎儿眼球各径线与胎儿性别和胎龄的相关性及胎儿眼球MRI形态学特征,为产前MRI诊断提供参考。方法回顾性分析2014年3月至2020年6月在复旦大学附属妇产科医院放射科行产前MRI检查无异常,且超声随访至出生前未见任何异常的胎儿MRI资料。在T2-HASTE横断面及矢状面上分别测量胎儿左、右眼球最大横径、前后径和上下径(两侧眼环外缘间最大距离),比较两侧眼球各测量值的差异性及与胎儿性别的相关性,并对各测量值与胎龄进行相关性分析和回归分析;观察孕中晚期不同胎龄正常胎儿眼球的MRI形态特征,并量化分析两侧眼球横径/前后径、横径/上下径及前后径/上下径随胎龄增长的变化规律。结果孕中晚期正常胎儿左、右两侧眼球横径、前后径及上下径无显著差异(t=0.198、-0.963、0.774),且与胎儿性别均不相关(r=-0.047、-0.040、-0.030、-0.022、-0.026、-0.026)。随胎龄增加,孕中晚期胎儿左、右眼球横径、前后径及上下径均呈高度线性增长(r=0.964、0.962、0.966、0.966、0.972、0.972,P均<0.001),线性回归方程分别为:左眼球横径(cm)=0.044×胎龄(周)+0.368(R2=0.930),右眼球横径(cm)=0.045×胎龄(周)+0.359(R2=0.926),左眼球前后径(cm)=0.049×胎龄(周)+0.078(R2=0.934),右眼球前后径(cm)=0.049×胎龄(周)+0.007(R2=0.933),左眼球上下径(cm)=0.044×胎龄(周)+0.242(R2=0.946),右眼球上下径(cm)=0.045×胎龄(周)+0.237(R2=0.945)。胎儿眼球形态由20周时的类锥体形态向38周时的近似球体形态转变,眼球横径/前后径、横径/上下径随胎龄增大逐渐减小,前后径/上下径随胎龄增长逐渐增大,晚孕期三者逐渐趋近于1.0,但眼球横径在整个孕中晚期始终最大。结论孕中晚期正常胎儿眼球发育具有对称性且与性别无关,眼球横径、前后径及上下径均随胎龄高度线性增长,眼球形态由类锥体向近似球体形态变化。Objective To analyze the correlation of eyeball diameters of normal fetuses with fetal gender and gestational age(GA)in the second and third trimesters,as well as the MRI morphological features of fetal eyeball,for providing reference for prenatal MRI diagnosis.Methods MRI data of fetuses who underwent prenatal MRI in Department of Radiology,Obstetrics and Gynecology Hospital,Fudan University from Mar 2014 to Jun 2020 were retrospectively analyzed.All fetuses had no abnormal findings in MRI and the subsequent ultrasound follow-up before birth.The left and right maximum transverse diameter of the eyeball(TDE),the upper-lower diameter of the eyeball(ULDE),and the anterior-posterior diameter of the eyeball(APDE)were measured in the transverse and sagittal T2-HASTE images(the maximum distance between the outer edges of the eye-rings),respectively.The correlation between the diameters and fetal gender was analyzed,as well as between the diameters and GA.Regression analyses were performed on the diameters and fetal age.MRI morphological features of fetal eyeballs in different GA in the second and third trimesters were observed,and the changing trends in TDE/APDE,TDE/ULDE and APDE/ULDE with the increasing GA were quantitatively analyzed.Results There were no significant differences between the left and right TDE,APDE and ULDE in normal fetuses in the second and third trimesters(t=0.198,-0.963,0.774,respectively),and none of them was related to fetal gender(r=-0.047,-0.040,-0.030,-0.022,-0.026 and-0.026,respectively).The left and right TDE,APDE and ULDE showed a highly linear increase with GA in the second and third trimesters(r=0.964,0.962,0.966,0.966,0.972,0.972,0.972,respectively,all P<0.001).The linear regression equations were as follows:left TDE(cm)=0.044×GA(wk)+0.368(R²=0.930),right TDE(cm)=0.045×GA(wk)+0.359(R²=0.926),left APDE(cm)=0.049×GA(wk)+0.078(R²=0.934),right APDE(cm)=0.049×GA(wk)+0.0073(R²=0.933),left ULDE(cm)=0.044×GA(wk)+0.242(R²=0.946),right ULDE(cm)=0.045×GA(wk)+0.237(R²=0.945).The fetal e

关 键 词：产前MRI 胎儿 眼球发育 孕中晚期 胎龄 

分 类 号：R714.51[医药卫生—妇产科学] R779.7[医药卫生—临床医学]