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二维超声联合煊影成像技术在早孕期中枢神经系统正常与异常胚胎/胎儿中的应用

Two-dimensional ultrasound combined with HD-live silhouette technology in embryos/fetuses with normal or abnormal central nervous system during early pregnancy

摘要目的:应用高分辨率二维超声联合煊影成像技术研究孕7~13周 +6中枢神经系统(central nervous system,CNS)正常和异常胚胎/胎儿的超声图像特征,为CNS异常的早期诊断提供参考。 方法:选取2020年1月至2020年12月在成都市妇女儿童中心医院早孕期(7~13周 +6)超声筛查CNS正常胚胎/胎儿80例,早孕期(孕11~13周 +6)CNS畸形胎儿41例,经阴道高分辨率二维超声联合煊影成像技术观察CNS正常及异常图像特征。对结果采用描述性分析。 结果:自孕7周起,高分辨率二维超声联合煊影成像技术可清晰立体地显示前、中和菱脑泡,脑胚胎发育菱脑泡的变化最大;9周时可见明显的脑桥曲、第四脑室和后颅窝池;10周时可见发育中的小脑和原始Blake陷窝囊肿;11~13周 +6时较10周变化最明显的第四脑室脉络丛由垂直于神经管的长轴变为与神经管长轴平行。41例CNS畸形胎儿中,16例(39.0%)露脑畸形,11例(26.8%)全前脑,5例(12.2%)脑膨出,4例(9.7%)无脑畸形,3例(7.3%)第四脑室扩张,2例(4.9%)开放性脊柱裂。 结论:高分辨率二维超声联合煊影成像技术可清晰立体地显示孕7~13周 +6CNS正常胚胎/胎儿发育形态学变化,有助于更好地理解CNS胚胎异常起源,为CNS异常的早期发现提供诊断线索。

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abstractsObjective:To study the ultrasonographic characteristics of embryos/fetuses with normal or abnormal central nervous system (CNS) from 7 to 13 +6 weeks of gestation using high resolution two-dimensional ultrasound combined with HD-live silhouette technology and provide a reference for early diagnosis of CNS abnormalities. Methods:Eighty normal embryos/fetuses during 7-13 +6 weeks and 41 fetuses with CNS malformations in early pregnancy during 11-13 +6 weeks were selected to observe the ultrasonographic features of embryos/fetuses with normal or abnormal CNS using transvaginal high resolution two-dimensional ultrasound and HD-live silhouette technology. Descriptive analysis was performed on the results. Results:From seven weeks of gestational age, high resolution two-dimensional ultrasound combined with HD-live silhouette technology can clearly and stereoscopically show the prosencephalon, mesencephalon and rhombencephalon. The rhombencephalon changed the most in the brain development of embryos. At nine weeks of gestation, cleared structures of pons curvature, the fourth ventricle and cisterna magna were observed. The developing cerebellum and the original Blake pouch cyst were seen at 10 weeks of gestation. From 11 to 13 +6 weeks, the most remarkable change was the choroid plexus of the fourth ventricle changed from perpendicular to parallel to the long axis of the neural tube. Of the 41 fetuses with CNS malformation, 16 (39.0%) were exencephaly, 11 (26.8%) were holoprosencephaly, five (12.2%) were encephalocele, four (9.7%) were anencephaly, three (7.3%) were fourth ventricle dilatation, and two (4.9%) were open spina bifida. Conclusions:High resolution two-dimensional ultrasound combined with HD-live silhouette technology can clearly and stereoscopically display the morphological changes in embryonic embryos/fetuses with development of normal CNS at 7-13 +6 weeks, which is helpful to better understand the origin of CNS embryonic abnormalities and provide diagnostic clues for the early detection of CNS abnormalities.

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中华围产医学杂志

中华围产医学杂志

2022年25卷5期

332-338页

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