胎儿侧脑室扩张的MR影像价值的相关性研究  

Correlation Study of MR Imaging Value in Fetal Ventriculomegaly

作　　者：逄利博 华荣[1] 安田田 翟敬芳[2] 刘敏[3] Pang Libo;Hua Rong;An Tiantian;Zhai Jingfang;Liu Min(MR.CT room,Xuzhou Central Hospital,Jiangsu 221009,China;Prenatal Diagnosis Center,Xuzhou Central Hospital,Jiangsu 221009,China;Department of Ultrasound,Xuzhou Central Hospital,Jiangsu221009,China)

机构地区：[1]江苏省徐州市中心医院MR,CT室,江苏徐州221009 [2]江苏省徐州市中心医院产前诊断中心,江苏徐州221009 [3]江苏省徐州市中心医院超声科,江苏徐州221009

出　　处：《中国产前诊断杂志(电子版)》2025年第1期31-37,共7页Chinese Journal of Prenatal Diagnosis(Electronic Version)

摘　　要：目的因为超声经常存在对胎儿侧脑室扩张和其他脑异常判断的不确定性,可能影响对胎儿侧脑室扩张程度及其他脑异常分类的问题。本研究通过评估磁共振成像(magnetic resonance imaging,MRI)两种测量方法与超声轴面测量的相关性及95%一致性,对MRI的测量方法及诊断价值进行客观探讨。方法回顾性分析2000年3月至2023年9月近3年江苏省徐州市中心医院进行胎儿头部MRI检查的孕产妇,对胎儿侧脑室轴面测量宽度≥10mm的177例,同时获取MRI冠状面测量值及超声轴面测量值,MRI和超声诊断的其他脑异常。每种测量方法均依据国际妇产科超声学会指南建议。结果通过对MRI轴面、冠状面与超声轴面三种测量均值的Spearman相关性和两两之间差值均值的95%一致性界限进行检验,三者之间的测量数值相关性均较佳,其中MRI轴面、冠状面之间的相关性最强,测量差值均值及95%一致性界限范围最小,一致性最佳。而MRI轴面与超声轴面测量差值均值最大,95%一致性界限的上限最大。当侧脑室扩张大于15mm时,合并其他严重脑异常明显增多,MR诊断29例,胼胝体缺如6例,胼胝体发育不全3例,大脑皮层发育不良2例,脑叶发育异常2例,空洞脑1例,全前脑畸形2例,室管膜下囊肿2例,Dandy-walker畸形4例,不典型Dandy-walker畸形7例。结论胎儿侧脑室的MRI轴面、冠状面与超声轴面三种测量方法间均有较好的相关性,以MRI轴面与冠状面之间最强,并且95%一致性最佳。同时MRI能补充诊断超声遗漏和误诊的其他脑异常。Objective Due to the diagnostic uncertainty of ultrasound in fetal Ventriculomegaly and other brain abnormalities,there were issues with the degree of fetal Ventriculomegaly and classification of other brain abnormalities.This study objectively explored the measurement methods and diagnostic value of MRI by evaluating the correlation and 95%consistency between two measurement methods of MRI and ultrasound axial measurement.Methods A retrospective analysis was conducted on 177 pregnant women who underwent fetal head MRI examinations from March 2000 to september 2023 in the past 3 years.The axial width of the fetal lateral ventricle was measured to be greater than 10mm,and MRI coronal and ultrasound axial measurements were obtained,as well as other brain abnormalities diagnosed by MRI and ultrasound.Each measurement method was based on the recommendations of the International Society of Obstetrics and Gynecology Ultrasound guidelines.Results By testing the Spearman correlation and 95%consistency limit of the mean values of MRI axial、coronal and ultrasound axial plane measurement,it was found that the correlation between the measurement value of this three planes was good.Among them,the correlation between MRI axial and coronal plane was strongest,the range of mean value of measurement difference and 95%consistency limit was smallest,and the consistency was best.The mean difference between MRI axial and ultrasound axial plane measurements was largest,and the upper limit of the 95%consistency limit was largest.When the expansion of lateral ventricle exceeded 15mm,there was a significant increase in other severe brain abnormalities.29 cases were diagnosed by MRI,including 6 cases of absence of the corpus callosum,3 cases of underdeveloped corpus callosum,2 cases of cerebral cortex dysplasia,2 cases of abnormal development of cerebral lobes,1 case of cerebral cavity,2 cases of whole forebrain malformation,2 cases of subarachnoid cysts,4 cases of Dandy Walker malformation,and 7 cases of atypical Dandy Walker malformat

关 键 词：胎儿侧脑室扩张 胎儿MRI MRI测量 MRI诊断 超声测量 

分 类 号：R714.53[医药卫生—妇产科学]