足月宫内胎儿脑的矢状断层影像解剖学研究

Sectional and imaging anatomy of the brain of full-term fetus intrauterine on the sagittal plane

目的:为给MR矢状图像精确定位宫内胎儿脑发育畸形及胎儿优生优育的MRI筛查提供断层解剖学依据。方法:将1例晚期妊娠尸体做腹盆部矢状位MR扫描,获取图像数据。用电动带锯按等距法制成与正中矢状面平行的腹、盆部连续矢状断层标本,并获取连续矢状断层标本图像数据,显示妊娠晚期宫内胎儿脑组织的形态结构。结果:(1)宫内胎儿头颅的倾斜及旋转方向的确定:胎儿为纵产式、头先露,胎头已经入盆,伴有颈部仰伸,胎体的前后位与孕妇一致,孕妇的正中矢状面图像与胎儿的正中矢状面图像一致,而且胎儿的头颅发生了向自己身体右侧的倾斜和旋转。(2)7幅标本的矢状断面图像是由孕妇左侧向右侧切及获得(胎体的右侧至左侧),分别经胎儿右侧大脑半球外侧凸面、外侧沟、内囊、正中矢状面、小脑中脚及脑干、左侧半球外侧凸面及左侧外侧沟。结论:宫内胎儿脑连续矢状断层标本和对应的MR图像对比分析结果显示了宫内胎儿脑的形态结构特征,能够为胎儿脑组织的胚胎发育和临床影像诊断提供正常的形态学资料。

Objective： To provide sectional and imaging data for the precise judgement of developmental malformation of fetal brain on sagittal MRI. Methods： After abdominal and pelvic MRI scanning, one gravid female corpse was cut into serial sagittal slices in correspondence with MRI in a low temperature lab to demonstrate and analyze the structures of fetal brain. Results. （1） Sloping and rotating directions of the fetal head were regarded as： the longitudinal lying and cephalic presentation, fetal head rupen and fetal neck extension. The anteroposterior position of the fetus and its images on the median sagittal plane were in correspondence with his mother＇s, and fetal head had rotated and sloped to his own right side; （2） 7 serial sagittal sections of the fetal brain were obtained through lateral surface of the right cerebral hemisphere, lateral sulcus, internal capsule, median sagittal plane, middle cerebellar peduncle and brain stem, lateral surface of the left cerebral hemisphere. Conclusions： Through the comparative study between sagittal sections and corresponding data of MRI of the brain of full-term fetus intrauterine, morphologic features of fetal brain can be obtained, which is reliable for understanding embryonic development of fetal brain and helpful for imaging diagnosis of developmental malformation.