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超声与MRI联合评估胎儿颅后窝池增宽的临床应用
作者:周婷1  曹荔1  陆小燕2  查文1 
单位:1. 南京市妇幼保健院 超声科, 江苏 南京 210004;
2. 南京市妇幼保健院 放射科, 江苏 南京 210004
关键词:超声 磁共振成像 胎儿颅后窝池 
分类号:R714.53
出版年·卷·期(页码):2017·36·第一期(62-66)
摘要:

目的:探讨超声联合核磁共振成像(MRI)检查评估胎儿颅后窝池增宽的价值。方法:选择121例超声检查发现胎儿颅后窝池增宽或可疑合并其他颅脑结构病变的胎儿为研究对象,其中43例于超声检查1周内行MRI检查。分别将超声、MRI的检查结果与产后随访结果进行对比分析。结果:颅后窝池宽度的超声测量值与MRI测量值差异无统计学意义(P=0.327)。两种检查方法结果一致的有34例(79%),超声较MRI提供更明确诊断结果1例(2.3%),MRI较超声提供更明确诊断结果10例(23%)。结论:产前超声对诊断和鉴别各种颅后窝池增宽的病因有重要临床意义;MRI检查可弥补超声检查因胎儿体位、羊水少及孕妇自身原因造成的局限性,还可发现更多颅脑结构病变,提供更明确的产前诊断信息。

Objective:To evaluate the clinical value of ultrasonography combined with MRI in prenatal diagnosis of fetal cisterna magna dilatation.Methods:One hundred and twenty-one fetuses diagnosed with cisterna magna dilatation or associate with additional central nervous system on ultrasonography enrolled this study,among them 43 fetuses were examined by MRI in one week after prenatal ultrasonography.The results of prenatal ultrasonography and MRI were retrospectively analyzed.Results:There was no significate difference in values of cisterna magna measuremed by ultrasonography or MRI(P=0.327).The same result were obtained in 34 fetuses (79%) by the ultrasonography or MRI,MRI provided more accurate informations than ultrasonography in 10 fetuses(23%),but less accurate in one fetus(2.3%).Conclusions:Ultrasonography is an effective method in diagnosis and differential diagnosis of fetal cisterna magna dilatation.Prenatal MRI have its own advantages and is an important supplement to ultrasound in fetuses with central nervous system and provide more accurate diagnosis.

参考文献:

[1] HIRSCH J F, PIERRE-KAHN A,RENIER D,et al.The Dandy-Walker malformation.A review of 40 cases[J].J Neurosurg,1984,61(3):515-522.
[2] FORZAN O F,MANSOU R S,LERULLO A,et al.Posterior fossa malformationgin fetuses:A reportof 56 further cases and a review of the literature[J].Prenat Diagn,2007,27(6):495-501.
[3] 陈欣林,杨小红,赵胜,等.超声和MRI在胎儿中枢神经系统畸形诊断中的对比应用[J].中华医学超声杂志:电子版,2007,4(6):353-357.
[4] TEE L M,KAN E Y,CHEUNG J C,et al.Magnetic resonance imaging of the fetal brain[J].Hong Kong Med J,2016,22(3):270-278.
[5] WANG G B,SHAN R Q,MA Y X,et a1.Fetal central nervous system anomalies:comparison of magnetic resonance imaging and ultrasonography for diagnosis[J].Chin Med J(Engl),2006,119(15):1272-1277.
[6] 张晓凡,张旭,朱凯,等.磁共振成像在产前胎儿颅脑疾病的临床应用价值[J].中国CT和MRI杂志,2012,10(6):25-28.
[7] 李胜利.胎儿畸形产前超声诊断学[M].北京:人民军医出版社,2010:126-156.
[8] Mc MILLAN J J,WILLIAMS B.Aqueduct stenosis:Case review and discussion[J].J Neurol Neurosurg Psychiatry,1977,40(6):521-532.
[9] BROWN R N.Reassessment of the normal fetal cisterna magna during gestation and an alternative approach to the definition of cisterna magna dilatation[J].Fetal Diagn Ther,2013,34(1):44-49.
[10] PASSOS A P,ARAUJO JUNIOR E,BRUNS R F,et al.Reference rang of fetal cisterna magna length and area measurements by 3-dimensional ultrasonography using the multiplanar mode[J].J Child Neurol,2015,30(2):209-215.
[11] BOLDUC M E,LIMPEROPOULOS C.Neurodevelopmental outcomes in children with cerebellar malformations:A systematic review[J].Dev Med Child Neurol,2009,51(4):256-267.
[12] GANDOLFI COLLEONI G,CONTRO E,CARLETTI A,et al.Prenatal diagnosis and outcome of fetal posterior fossa fluid collections[J].Ultrasound Obstet Gynecol,2012,39(6):625-631.
[13] CHIOU Y M,TSAI C H.Axiod sonographic features of Dandy-walker variant withoccipital cephalocele[J].J Chin Ultrasound,1992,20(2):139-141.
[14] 孟新月,解丽梅.超声和鉴别诊断胎儿颅后窝池畸形[J].中国医学影像技术,2013,29(5):837-840.
[15] PREDA O,NICOLAE A,LOGHIN A,et al.Retroperitoneal seminoma as a first manifestation of apartially regressed(burnt-out)testicular germ cell tumor[J].Rom J Morphol Embryol,2011,52(1):193-196.
[16] NIGRI F,CABRAL I F,Da SILVA R T,et al.Dandy-walker malformation and down syndrome association:good development outcome and successful endoscopic treatment of hydrocephalus[J].Case Rep Neurol,2014,6(2):156-160.
[17] ROBINSON A J,BLASER T S,TOI A,et al.The fetal cerebellar vermis assessment for abnormal development by ultrasonographyand magnetic resonance imaging[J].Ultrasound Q,2007,23(3):211-223.
[18] 沈敏花,张国福,王雪珍,等.MRI中C位线扫描在显示胎儿颅后窝池异常中的应用[J].中国医学计算机成像杂志,2015,21(5):492-496.
[19] GUIBAUD L,LARROQUE A,VILLE D,et al.Prenatal diagnosis of "isolated" Dandy-Walker malformation:imaging findings and prenatal counselling[J].Prenat Diagn,2012,32(2):185-193.
[20] SCOTT J A,HAMZELOU K S,RAJAGOPALAN V,et a1.3D morphometric analysis of human fetal cerebellar development[J].Cerebellum,2012,11(3):761-770.
[21] ARAUJO JUNIOR E,PASSOS A P,BRUNS R F,et al.Reference rang of fetal cisterna magna volume by three-dimensional ultrasonography using the VOCAL method[J].J Matern Fetal Neonatal Med,2014,27(10):1023-1028.
[22] NARDOZZA L M,PASSOS A P,ARAUJO JUNIOR E,et al.Reference intervals of fetal cisterna magna volume by two-dimensional method using the multiplanar mode of three-dimensional ultrasonography[J].Radiol Bras,2014,47(4):201-205.
[23] BERNARDES L S,AKSNES G,SAADA J,et al.Keyhole sign:how specific is it for the diagnosis of posterior urethral valves[J].Ultrasoud Obstet Gynecol,2009,34(4):419-423.
[24] NELSON M D Jr,MAHER K,GILLES F H.A different approach to cysts of the posterior fossa[J].Pediatr Radiol,2004,34(9):720-732.
[25] PALADINI D,QUARANTELLI M,PASTORE G,et al.Abnormal or delayed development of the posterior membranous area of the brain:anatomy,ultrasound diagnosis,natural history and outcome of Blake's pouch cyst in the fetus[J].Ultrasound Obstet Gynecol,2012,39(3):278-297.

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