产前超声发现胎儿透明隔腔异常与MRI的对比
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1.南京医科大学附属妇产医院超声科(南京市妇幼保健院);2.南京医科大学附属妇产医院超声科

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]南京市卫生科技发展项目 YKK21165 *[


Prenatal ultrasound findings of fetal septum pellucidumabnormalities were compared with MRI
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    摘要:

    目的:探讨产前超声发现胎儿透明隔腔异常的临床价值,并与MRI对比。方法:将我院产前超声发现的52例胎儿透明隔腔异常,与MRI结果对比,分析两者的诊断符合率并统计伴发畸形情况,同时追踪所有病例的产前诊断结果及妊娠结局,并随访新生儿神经系统发育情况。结果:52例超声提示透明隔腔异常的胎儿中,透明隔腔增宽7例(13.46%),透明隔腔窄小7例(13.46%),透明隔腔未显示35例(67.31%),透明隔腔形态异常3例(5.77%)。超声与MRI诊断结果符合的为39例(75.00%),不符的8例(15.38%),MRI对超声结果有补充的为5例(9.62%)。超声与MRI均提示透明隔腔异常的44例中,孤立性透明隔腔异常为23例(52.27%),含7例窄小,6例增宽,10例未显示。21例(47.73%)为透明隔腔异常有伴发畸形,含17例未显示,3例形态异常,1例增宽。其中19例为伴发中枢神经系统畸形,胼胝体缺如占12例,均为完全性胼胝体缺如。染色体情况分析,除1例(病例3号)经羊膜腔穿刺CMA结果为15号染色体异常,余51例未见异常。妊娠结局情况分析,13例引产,1例失访,余38例继续妊娠。新生儿随访至6个月,除1例(病例15号)出现神经系统发育迟缓,余37例均未见明显神经系统异常。结论:产前超声是筛查胎儿透明隔腔异常及伴发畸形的主要方法,MRI是重要的补充检查方式,尤其是观察胎儿大脑皮层的发育情况具有较大优势。产前鉴别孤立性透明隔腔异常或伴发畸形对胎儿的预后评估至关重要,孤立性透明隔腔异常的胎儿预后较好。

    Abstract:

    Objective:To evaluate the clinical value of prenatal ultrasound in detecting fetal septum pellucidum abnormalities and compare it with MRI. Methods:Fifty-two cases of fetal clear septum abnormalities detected by prenatal ultrasound were compared with MRI findings, The diagnostic coincidence rate of the two methods was analyzed, all cases were followed up for prenatal diagnosis and pregnancy outcome, and follow-up neonatal nervous system development .Results:Among the 52 fetuses with abnormal septum pellucidum, 7 had enlarged septum pellucidum(13.46%),the transparent septum was small in 7 cases (13.46%) , the transparent septum was not shown in 35 cases (67.31%)and 3 cases (5.77%) had abnormal shape of septum pellucidum. The coincidence rate of ultrasound and MRI was 39 cases (75.00%) , and that of non-coincidence was 8 cases (15.38%),SMRI was complementary to ultrasound findings in 5 cases (9.62%). Both ultrasound and MRI showed abnormal septum pellucidum in 44 cases, 23 cases were isolated hyaline septum abnormality(52.27%),there were 7 cases of narrow, 6 cases of wide, 10 cases did not show. 21 cases(47.73%) had abnormal septum pellucidum with associated malformation, there were 17 cases not shown, 3 cases with abnormal shape, 1 case with widening. Nineteen of them were associated with central nervous system malformation , Complete absence of the corpus callosum was found in 12 cases . Chromosome analysis , except for one case (Case 3)amniocentesis CMA revealed chromosome 15 abnormalities, the other 51 cases were normal .Analysis of pregnancy outcome, 13 cases induced labor, 1 case lost to follow-up, the remaining 38 cases continued pregnancy . The newborn was followed up for 6 months, except for 1 case (case 15) with delayed development of nervous system, the other 37 cases had no obvious nervous system abnormality. Conclusions:Prenatal ultrasound is the main method for screening fetal Septum pellucidum abnormalities and associated anomalies, MRI is an important complementary examination, Especially the observation of fetal cerebral cortex development has a greater advantage. Prenatal identification of isolated clear septum abnormalities or associated anomalies is essential for fetal evaluation, the prognosis of the fetus with isolated hyaline septum abnormality is better.

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  • 收稿日期:2022-10-08
  • 最后修改日期:2023-01-25
  • 录用日期:2023-07-09
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