孕11～13^(+6)周胎儿颅内透明层在开放性脊柱裂的诊断价值分析

The clinical value of intracranial translucency(IT)in open spina bifida at 11-13^(+6) weeks of gestation

目的探讨孕11～13^(+6)周胎儿颅内透明层在开放性脊柱裂的诊断价值。方法选取2016年9月至2017年12月期间200例正常胎儿与6例开放性脊柱裂的胎儿,采用腹部超声检查,观察孕11～13^(+6)周开放性脊柱裂胎儿正中矢状切面颅内透明层、间脑、中脑的形态有无异常改变。结果 200例正常胎儿孕11-13^(+6)周正中矢状切面颅内透明层均能清晰显示,间脑和中脑呈现"8"字形态;6例开放性脊柱裂胎儿颅内透明层变小或消失,间脑和中脑"8"字形态有不同程度的变形和扭曲。孕11～13^(+6)周开放性脊柱裂胎儿正中矢状切面,胎儿的脑部因颅内负压导致颅内透明层、间脑及中脑表现出形态改变。结论孕11-13^(+6)周胎儿颅内透明层、间脑及中脑脑部形态改变为孕11～13周开放性脊柱裂提供了诊断依据。

Objective To explore the clinical value of intracranial translucency （IT） in open spina bifida at 11 - 13 ＋ 6 weeks of gestation. Methods Abdominal ultrasound was performed in 200 cases of nor- mal fetus and 6 cases of confirmed open spina bifida at 11 - 13 ＋6 weeks of gestation to compare the morphol- ogy of IT, diencephalon and midbrain. Results Fetal IT was readily recognized in all 200 normal cases, with diencephalons and midbrain showing number ＂8＂ shape. In 6 cases of open spina bifida, fetal IT can- not be identified, and the expected ＂8＂ shape of diencephalon and midbrain was distorted. During 11 - 13 ＋6 weeks of pregnancy, the fetal brain is caused by intraeranial negative pressure, resulting in morpholog- ical changes in the intracranial hyaline, dieneephalon and mesencephalon. Conclusions Fetal brain char- acteristics including intracranial translucency and the shape of dieneephalon and midbrain in 11 -13 ＋6 weeks gestation are valuable ultrasound screening indicators for opens pina bifida.