胎儿中枢神经系统畸形的产前超声应用研究

Application value of prenatal ultrasound diagnosis on fetal central nervous system malformation

目的探讨中枢神经系统(CNS)畸形胎儿产前超声诊断表现,并与磁共振成像(MRI)及病理诊断结果进行比较,对超声诊断价值进行分析。方法纳入2018年1月—2020年1月于南阳市第一人民医院进行产前超声检查发现胎儿CNS畸形并采用磁共振成像(MRI)补充诊断依据确诊的孕妇66例,收集并整理其临床档案资料,通过回顾性分析脑室异常改变情况,总结超声诊断表现特征及其相关畸形症状,并比较超声与MRI及病理诊断结果。结果分娩新生儿中枢神经畸形筛查结果及终止妊娠胎儿病理诊断CNS畸形63例。超声检出Dandy-Walker综合征19例,脊柱裂16例,严重脑积水14例,前脑无裂畸形9例,胼胝体缺失8例;MRI检出Dandy-Walker综合征19例,脊柱裂15例,严重脑积水14例,前脑无裂畸形7例,胼胝体缺失8例;经MRI补充发现与超声诊断结果相符的病例有26例,对超声诊断信息予以补充、更正的病例分别有35例、3例,与超声诊断结果不符合病例有2例;两种诊断方法结果比较,差异无统计学意义(P>0.05)。结论孕妇行产前超声可通过动态显影观察胎儿CNS发育情况,并根据超声结果明确脑室异常改变,从而有效诊断鉴别CNS畸形,可为临床诊疗提供较高价值的病理依据,颇具良好应用价值。

Objective To investigate the prenatal ultrasound diagnosis of central nervous system(CNS)malformed fetuses,compare the results with magnetic resonance imaging(MRI),and analyze the value of ultrasound diagnosis.Methods Included in from January 2018 to January 2020 in our hospital for prenatal ultrasonic examination found that CNS malformation fetus and the use of magnetic resonance imaging(MRI)supplementary diagnosis confirmed 66 cases of pregnant women,collected and sorted the clinical profiles,through a retrospective analysis of abnormal changes of ventricle,summarized the ultrasonic diagnosis of performance characteristics and its related abnormalities symptoms,and compare the cases of ultrasound and MRI diagnosis.Results Ultrasonography detected 19 cases of Addy-Walker syndrome,16 cases of spina bifida,14 cases of severe hydrocephalus,9 cases of holoencephalopathy,and 8 cases of corpus callosum deletion.MRI detected 19 cases of Addy-Walker syndrome,15 cases of spina bifida,14 cases of severe hydrocephalus,7 cases of holoencephalopathy and 8 cases of corpus callosum deletion.There were 26 cases that were found to be consistent with ultrasonic diagnosis by MRI supplement,35 cases that were supplemented and corrected with ultrasonic diagnosis information,and 3 cases that were not consistent with ultrasonic diagnosis results.There was no significant difference between the two diagnostic methods(P>0.05).Conclusion Prenatal ultrasound in pregnant women can observe the development of fetal CNS by dynamic imaging,and the abnormal changes of ventricle can be identified according to the ultrasound results,so as to effectively diagnose and differentiate CNS deformity,which can provide a high value of pathological basis for clinical diagnosis and treatment,and has good application value.