超声诊断胎儿中枢神经系统畸形的价值

背景应用超声诊断胎儿中枢系统畸形已成为常用方法,但对胚胎发育过程中组织学特征与畸形相关性的细致研究尚不多.目的探讨超声诊断胎儿中枢神经系统畸形的价值及畸形特征与诊断准确率的关系.设计回顾性研究.地点、对象和方法对美国加州一产前诊断中心5年中超声发现的148例中枢神经系统畸形的孕妇胎儿检查结果进行声像图特点分析.主要观察指标148例中枢神经系统畸形的孕妇胎儿胎头双顶径、头围、侧脑室、延髓池、脑中线、颅骨光环、脊柱形态、羊水量超声检查结果.结果148例中枢神经系统畸形胎儿中,无脑儿32例,脑积水3l例,积水性无脑4例,脑膜或脑脑膜膨出11例,脊柱裂脊膜膨出者25例,Dandy-Walker畸形12例,前脑无裂畸形11例,脉络丛囊22例,不同类型的中枢神经系统畸形有不同声像图表现,并与其胚胎发育过程异常相关.结论高分辨率超声能准确地发现胎儿中枢神经系统各种畸形,在胎儿中枢神经系统畸形的诊断中有重要价值.

Significance of ultrasonic diagnosis in fetuses with deformities of central nervous system

BACKGROUND: Ultrasonic diagnosis has been a useful method in fetuses with central nervous system (CNS) deformities. But further study about the correlation between histological features and these deformities during the developmeut of embryo is rare.OBJECTIVE: To study the significance of ultrasonic diagnosis in fetuses with CNS deformities and the relationship between deformity features and the accuracy rate of diagnosis.DESIGN: A retrospective study.SETTING, PARTICIPANTS and INTERVENTIONS: Ultrasound images of 148 fetuses with CNS deformities were analyzed who were discovered through ultrasonic exanfination in a Prenatal Diagnostic Center in California of USA within 5 years.MAIN OUTCOME MEASURES: Biparietal diameter of fetal head, head circunfference, lateral ventricle, medullary cistern, brain median line, diaphragm of cranial bone, appearance of vertebral column and quantity of amniotic fluid were observed through ultrasonic examination.RESULTS: Thirty-two cases were anencephalia, 31 hydrocephalus, 4 hydroancncephalus, 11 neningocele or encephalomeningocele, 25 spinal meningocele with myeloschisis, 12 Dandy-Walker deformity, 11 schizencephaly of forebrain and 22 choroid plexus cyst among the 148 fetuses. There were different expressions in various CNS deformities, which were correlated with abnormal development of embryo.CONCLUSION: Ultrasound of high resolving power can accurately discover fetuses with different CNS deformities and which is of great significance in diagnosing these deformities.