中、晚孕胎儿颅脑横切面组合在畸形筛查中的应用

Application of fetal brain combined transverse views in scanning abnormalies during the second and third trimesters of pregnancy

目的探讨胎儿颅脑横切面组合的声像图特征及其筛查先天性颅脑畸形的价值。方法 回顾性分析2005年7月—2010年1月14595名接受中、晚孕胎儿彩色超声检查的孕妇资料,对胎儿颅脑的三个横切面组合进行观察,包括:双顶径切面、侧脑室水平横切面、经小脑横切面,观察的内容主要包括:颅骨光环的完整性、脑中线是否居中;侧脑室是否对称、脉络丛的回声有无异常;颅后窝结构有无明显异常;大脑皮质、脑沟及脑回的发育有无异常等。结果 14595胎胎儿颅脑超声检查,共筛查出50胎颅脑畸形,其中引产的48胎尸检结果与产前超声诊断相符,2胎失访。15胎畸形胎儿接受脐带血穿刺检查,检出1胎18-三体,1胎21-三体。结论 胎儿颅脑横切面组合在筛查先天性颅脑畸形中有重要价值。

Objective To explore the sonographic features of the axial views combination images in fetal brain scan,and to observe their value in detecting congenital brain abnormalities.Methods A retrospective study on 14 595 pregnancies who underwent fetal color ultrasound scan from July 2005 to January 2010 was performed.The basic combined cross-section views of fetal head were observed,including biparietal diameter level,the lateral ventricle level and the transcerebellar cross-section.The important observing contents included the integrity of the skull,position of the brain midline,the symmetry of lateral ventricles,echo of choroid plexuses as well as whether posterior fossa structures,development of the cerebral cortex,groove and gyrus were abnormal.Results In 14 595 fetuses,50 brain abnormalities were screened out,of which 48 underwent postmortem examination and the results were consistent with prenatal ultrasonographic diagnosis,and the other 2 fetuses were lost to follow-up.Fifteen fetuses were detected umbilical cord blood for chromosome abnormalities,of which 1 fetus was 18 trisome and 1 was 21 trisome.Conclusion The group of fetal head transverse views is very important for scanning congenital brain malformations.