产前超声诊断胎儿颅内蛛网膜囊肿并预测其转归  

Prenatal ultrasound for diagnosing fetal intracranial arachnoid cyst and predicting outcomes

作　　者：张国慧 孙丽娟[1] 郭翠霞[1] 崔元杰 ZHANG Guohui;SUN Lijuan;GUO Cuixia;CUI Yuanjie(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院、北京妇幼保健院超声科,北京100026

出　　处：《中国医学影像技术》2025年第3期372-376,共5页Chinese Journal of Medical Imaging Technology

基　　金：北京市高层次公共卫生人才建设项目(学科骨干-02-06)。

摘　　要：目的观察产前超声胎儿颅内蛛网膜囊肿(IAC)及预测其转归的价值。方法回顾性纳入经胎儿颅脑MR检查或临床随访证实的240胎IAC胎儿,观察其产前超声表现,随访妊娠结局,记录出生后神经系统发育及治疗情况,将其分为“转归良好”与“转归差”组。采用单因素及二元logistic回归分析胎儿临床资料及产前超声表现,筛选其转归的影响因素。结果240胎IAC中,192胎(192/240,80.00%)位于小脑幕上区、48胎(48/240,20.00%)位于小脑幕下区;大小0.3~6.2 cm、平均(1.4±0.9)cm;230胎(230/240,95.83%)为单发、10胎(10/240,4.17%)为多发。产前超声均表现为颅内边界清楚的薄壁囊性回声,内部透声好;其中150胎(150/240,62.50%)为单纯IAC、90胎(90/240,37.50%)IAC合并颅内或其他系统畸形。其后189胎顺利分娩、51胎接受引产。对189例新生儿随访至出生后6~84个月。240胎IAC中,171胎(171/240,71.25%)转归良好、69胎(69/240,28.75%)转归差。产前超声显示IAC大小、数目、是否合并畸形及性别均为胎儿IAC转归的独立影响因素(OR=1.558、6.323、0.911、2.662,P均<0.05)。结论产前超声可准确诊断胎儿IAC并预测其转归。Objective To observe the value of prenatal ultrasound for diagnosing fetal intracranial arachnoid cyst(IAC)and predicting outcomes.Methods A total of 240 fetuses with IAC confirmed by fetal brain MR examination or clinical follow-up were retrospectively enrolled,and the prenatal ultrasonic manifestations were observed.The outcomes of pregnancy were recorded,and the neurological development and treatment after birth were regularly followed up,then the fetuses were classified into good outcome or poor outcome groups.Univariate and binary logistic regression were used to analyze clinical data and prenatal ultrasonic findings,and the impact factors of outcomes of fetal IAC were screened.Results Among 240 fetuses,IAC located in the supratentorial area in 192(192/240,80.00%)and in the infratentorial area in 48(48/240,20.00%)fetuses.The size of IAC was 0.3-6.2 cm,with an average of(1.4±0.9)cm.Single lesion was found in 230 fetuses(230/240,95.83%),while multiple lesions were detected in 10 fetuses(10/240,4.17%).IAC presented as thin-walled cystic echoes with clear intracranial boundaries and good intracapsular sound transmission in all 240 fetuses,including 150(150/240,62.50%)with simple IAC and 90(90/240,37.50%)complicated with intracranial or other system malformations.Totally 189 fetuses were delivered successfully,while 51 underwent induction of labor.The newborns were followed up to 6-84 months.Among 240 fetuses with IAC,171(171/240,71.25%)had good outcome and 69(69/240,28.75%)had poor outcome.The size,number of lesion and whether combined with malformations or not on prenatal ultrasound and gender were all independent impact factors of outcomes of fetal IAC(OR=1.558,6.323,0.911,2.662,all P<0.05).Conclusion Prenatal ultrasound could accurately diagnose and predict the outcomes of fetal IAC.

关 键 词：蛛网膜囊肿 胎儿 超声检查 产前 治疗结果 

分 类 号：R714.53[医药卫生—妇产科学] R445.1[医药卫生—临床医学]