三维超声评估胎儿脊髓圆锥位置的定位研究

The positioning study of three-dimensional ultrasound in the evaluation of fetal conus medullaris location

目的探讨三维超声评估胎儿脊髓圆锥位置的定位效果。方法回顾性分析116例接受常规产前系统超声筛查的中晚孕单胎妊娠孕妇的临床资料,观察三维超声对胎儿脊髓圆锥末端显示率,比较胎儿不同孕期脊髓圆锥末端位置水平差异。结果脊髓圆锥末端位置清晰显示率为94.8%(110/116);三维超声筛查正常110例,异常6例,其中4例引产、2例娩出后经核磁共振成像确诊,脊柱裂类型:终丝紧张2例,皮毛窦1例,终丝脂肪瘤1例,脊髓脂肪瘤2例。正常胎儿不同孕周圆锥位置均在L3及以上,且随着孕周增加,位置逐渐上升。异常胎儿脊髓圆锥位置主要在L4或更低,虽然随孕期增加位置有所增加,但仍然低于正常水平。结论中晚期随着孕周增加,胎儿脊髓圆锥位置出现线性上升;三维超声能够准确显示不同阶段胎儿脊椎圆锥位置,可作为胎儿脊柱裂的主要声像指标。

Objective To investigate the positioning effect of three-dimensional ultrasound in the evaluation of fetal conus medullaris location.Methods The clinical data of 116 middle-late single pregnancy pregnant women who received conventional prenatal ultrasound screening were retrospectively analyzed.The display rate of terminal of fetal conus medullaris by three-dimensional ultrasound was observed,the level difference of terminal position of fetal conus medullaris at different stages of pregnancy were compared.Results The clear display rate of terminal position of fetal conus medullaris was 94.8%(110/116).Three-dimensional ultrasound screening was normal in 110 cases and abnormal in 6 cases,among which 4 cases were induced labor and 2 cases were diagnosed by nuclear magnetic resonance imaging after childbirth.Types of spina bifida:2 cases of terminal filament tension,1 cases of dermal sinus,1 case of terminal filament lipoma,and 2 cases of spinal lipoma.The cone position of normal fetus in different gestational weeks were L3 and above,and with the increase of gestational weeks,the position gradually increased.Abnormal fetal conus medullaris were mainly located in L4 or lower,although the position increased with pregnancy,but still lower than normal level.Conclusion With the increase of gestational age,the position of fetal conus medullaris increase linearly in the middle and late stages of pregnancy.Three-dimensional ultrasound can accurately display the position of fetal conus medullaris at different stages,and can be used as the main ultrasound index of fetal spina bifida.