产前三维超声诊断及评价胎儿半椎体

Three-dimensional ultrasound in prenatal diagnosis and assessment of fetal hemivertebra

目的探讨三维超声诊断胎儿半椎体及所致脊柱侧弯的价值。方法对中晚期妊娠正常胎儿30胎及9胎二维超声疑诊半椎体胎儿进行三维超声检查,与X线片及引产后数据进行对照。结果三维超声对30胎正常胎儿脊柱冠状面的显示率为100%(30/30),二维超声仅为30.00%(9/30)。9胎疑诊半椎体胎儿中,7胎为半椎体,2胎为蝴蝶椎、半椎体混合畸形。对超声发现的8胎脊柱侧弯胎儿测量Cobb角,与X线测量结果差异无统计学意义(t=0.11,P=0.91)。结论三维超声有助于诊断及评价胎儿半椎体,可为产前评估胎儿半椎体和判断预后提供更多信息。

Objective To explore the value of three-dimensional ultrasound （3D-US） in prenatal diagnosis of fetal hemivertebra and assessment of scoliosis caused by hemivertebra. Methods Ultrasonic data of 30 healthy fetuses in the second or third trimester and 9 fetuses with suspected hemivertebra were obtained. Comparison with radiographic findings and other data obtained after birth or induced abortion was performed. Results In normal fetuses, the display rate of 3D-US for the coronal plane of fetal spines was 100% （30/30）, of two-dimensional ultrasound was 30.00% （9/30）. Among 9 fetuses with suspected hemivertebra, hemivertebra was found in 7, while mixed malformations （butterfly vertebra and hemivertebra） were found in 2 fetuses. 3D-US detected scoliosis in 8 fetuses, and the measurement results of Cobb angle with 3D-US were not statistically different compared with those of radiography （t=0.11, P=0.91）. Conclusion Three-dimensional ultrasonography is helpful to detection and evaluation on hemivertebra in developing fetus, which can provide more evidence for consultant and prognosis of fetal hemivertebra.