二维超声多切面连续扫查联合多种三维成像技术在胎儿脊柱骶尾部微小病变中的诊断价值

The value of two-dimensional continuous scanning with multiple sections in combination with various 3D imaging techniques in the diagnosis of minimal change in caudal sacral spine of the fetu

目的分析二维超声不同切面及三维超声不同成像技术对于提高脊柱骶尾部微小病变检出率的应用价值。方法选取在医院进行产前诊断并确认的14例脊柱骶尾部微小病变胎儿,比较二维超声连续扫查中,不同切面对于提高脊柱骶尾部微小病变检出率的意义,比较三维表面成像和骨成像对于不同脊柱骶尾部微小病变检出的敏感性。结果 14例脊柱骶尾部微小病变胎儿均经生后体格检查及影像学检查确诊,包括半椎体5例,无症状的骶尾部骨化中心排列欠规整4例,皮毛窦1例,脂肪脊膜膨出1例,椎管内异常回声2例,脊柱纵裂1例。除脊柱纵裂1例漏诊,其余13例均经产前超声检查检出。对于脊柱微小病变二维超声连续扫查横切面及冠状切面检出率优于正中及旁正中矢状切面。三维表面成像及骨成像可以有针对性地提高不同的脊柱骶尾部微小病变检出率。结论二维超声多切面连续扫查联合多种三维成像技术能够显著提高胎儿脊柱骶尾部微小病变的检出率。

Objective To analyze the clinical value of two-dimensional ultrasound with different sections and three-dimensional ultrasound imaging techniques in improving the detection rate of small lesions in the spinal caudal region.Methods Fourteen cases of fetal minimal change in spinal caudal region were analyzed in this study.The detection rate of two dimensional ulstrasound continuous scanning with different sections were compared.The detection sensitivity of different spinal sacral lesions was analyzed by three-dimensional surface imaging and bone imaging.14 cases of spinal lesions were confirmed by postnatal fetal physical and imaging examination,including 5 cases of asymptomatic hemivertebra,4 cases of less structured sacrococcygeal ossification center,1 case of pilonidal sinus,1 case of fat meningocele,2 cases of intraspinal abnormal echo and 1 case of diastematomyelia.Except for 1 case misdiagnosis of diastematomyelia,13 cases were detected by prenatal ultrasound examination.Results For the detection of minimal change in caudal sacral spine,transverse and coronal sections are superior to the median and parasagittal sections in two dimensional continuous scan.Three dimensional surface imaging and bone imaging can improve the detection rate of different lesions.Conclusion Two dimensional continuous scanning with multiple sections combined with various three-dimensional imaging techniques can significantly improve the detection rate of minimal change in caudal sacral spine of the fetus.