三维超声最大透明成像技术对胎儿颅骨解剖结构的检测

Three-dimensional static maximum value translucent rendering ultrasound detecting fetal skull bones structure and formation

目的 探讨三维超声立体直观检测胎儿颅骨解剖形态和结构的方法。方法 采用静态最大 透明回声成像模式,对64例12～40孕周胎儿颅骨的形态和解剖结构进行三维重建,以直接显示胎儿颅骨 的总体解剖结构、各组成部分的特征和相互关系。结果 颅骨前方、侧后方和顶部的三维重建显像率分别 为93.75%、84.34%和60.94%。孕21～32周为胎儿颅骨整体三维重建成像的最佳时段,前方和侧后方 的成像率可达100%,顶部成像率高于70%。重建成功后可以显示具备眼眶、鼻腔、上下颌骨间隙的颅面 部外观,颅骨形态立体直观,解剖层次分明,颅顶大小囟门,各骨骼的边界和相互连接亦清晰易辨。结论 三维超声能全面、直观、形象地显示胎儿颅骨的总体和各组成部分的生长发育状况、解剖形态和相互关系, 对颅部疾病的形态表达和空间定位诊断优于二维超声。

Objective To detect the anatomic formation, structure of the fetal skull bones by three-dimensional(3D) ultrasound technique. Methods Sixty-four cases of fetal skull bone 3D formation and structural images were reconstructed with the range from 12 to 40 gestational weeks by means of static maximum value translucent rendering mode. Results The successful rate of fetal skull bone's formation and structure in facial, lateral and back, vertex position with the 3D image was 93.75%, 84.34% and 60.94% respectively in the total of 64 cases. However, during the gestation of 21～32 weeks, above reconstructive rates increased to 100%, 100% and higher than 70% respectively when an integrated fetal skull bone structure was formed easily. In the coronal and lateral image, the integrated skull structure image with two orbits, nasal cavity and oral cavity were clear and identified easily. All part of skull bone, positional relationship among them with the relevant sutures and fontanels were displayed. Conclusions 3D ultrasound can supply more detailed and comprehensive information of fetal skull bones. The values on the expression of abnormal position and formation are much better than that of two dimensional ultrasound.