北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (2): 319-322.

• 论著 • 上一篇    下一篇

胎儿半椎体的产前超声表现及临床意义

张韩珉,胡波,林霞,付庆明,周碧华,姜智南△   

  1. (浙江省宁波市妇女儿童医院超声科,浙江宁波315010)
  • 出版日期:2014-04-18 发布日期:2014-04-18

Prenatal ultrasonic manifestation and clinical significance of fetal hemivertebra

ZHANG Han-min, HU Bo, LIN Xia, FU Qing-ming, ZHOU Bi-hua, JIANG Zhi-nan△   


  1. (Department of Ultrasonography, Women & Children’s Hospital, Zhejiang Ningbo 315010, China)
  • Online:2014-04-18 Published:2014-04-18

摘要: 目的:探讨胎儿半椎体畸形的产前超声表现及产前超声检查的临床意义。方法:回顾性分析浙江省宁波市妇女儿童医院经产后影像学检查(X线、CT或MR)诊断为半椎体畸形的27例病例(包括引产及足月产儿),所有病例产前均行胎儿超声及MR检查。分析半椎体的二维及三维产前超声表现,并将产前超声、产前MR与产后影像学检查进行对比分析。对所有胎儿进行染色体核型检查,对足月产儿行手术治疗并计算Cobb角矫正率。结果:27例胎儿超声检查均可见脊柱形态改变,受累节段仅有一半椎体,其中单发9例,多发18例;8例未合并畸形,19例均合并其他畸形。27例胎儿,引产19例,8例足月分娩。与产后X线等影像学检查比较,产前超声准确率92.5%,产前MR准确率96.3%。27例胎儿,染色体培养成功25例,正常核型68.0%(17/25),异常核型32.0%(8/25),其中多发半椎体畸形异常核型占47.1%(8/17)。8例患儿行后路半椎体切除术,≤3岁组6例,Cobb角矫正率平均38.02%;>3岁组2例,Cobb角矫正率平均24.98%。结论:胎儿半椎体畸形具有较典型的超声表现,产前超声诊断胎儿半椎体畸形的准确性接近MR,其对半椎体畸形的诊断及对胎儿合并畸形的整体评估具有重要的临床意义,可为优生优育及遗传咨询提供有价值的参考。

关键词: 脊柱, 先天畸形, 超声检查, 产前, 磁共振成像, 半椎体

Abstract: Objective: To explore the manifestation and clinical significance of prenatal ultrasound diagnosis of fetal hemivertebra. Methods: In the study, 27 fetals with hemivertebras (proven by post-natal X-ray, CT or MR) were examined by prenatal ultrasound and MR in Women & Children’s Hospital, Ningbo, Zhejiang. Two-dimensional and threedimensional prenatal ultrasonic manifestations were retrospective analyzed and compared with the prenatal MR diagnoses, the post-natal X-ray, CT, MR examinations. All the fetuses were carried out karyotype examinations. The full-term births recieved surgical treatment and the Cobb angle correction rate was calculated. Results: The 27 cases of fetal ultrasound showed the morphological changes of the spine, with the involved segment only half of the vertebra, in which 9 cases were single hemivertebra and 18 cases multiple, 8 cases were no malformation and 19 cases other malformations, and 19 cases were induction of labor, and 8 cases of term delivery. Compared with postpartum X-ray and other imaging tests, the prenatal ultrasound accuracy rate was 92.5%, and prenatal MR 96.3%. In the 27 cases, the chromosome cultures of 25 cases were successful, in which the normal karyotype was 68.0% (17/25), and abnormal karyotype 32.0% (8/25) with multiple hemivertebra accounting for 47.1% (8/17). In 8 cases with posterior approach of hemivertebra resection, 6 patients were less than and equal to 3 years old, whose average Cobb angle correction rate was 38.02%, and 2 more than 3 years old, whose average Cobb angle correction rate was 24.98%. Conclusion: Fetal hemivertebra have typical sonographic manifestations. In diagnosis of fetal hemivertebra, the accuracy of prenatal ultrasound is close to that of MR, which has important clinical implications in diagnosis and overall assessment of fetal hemivertebra, and can also provide appropriate clinical genetic reference.

Key words: Spine, Congenital abnormalities, Ultrasonography, prenatal, Magnetic resonance imaging, Hemivertebra

[1] 邢念增,王明帅,杨飞亚,尹路,韩苏军. 前列腺免活检创新理念的临床实践及其应用前景[J]. 北京大学学报(医学版), 2024, 56(4): 565-566.
[2] 田宇轩,阮明健,刘毅,李德润,吴静云,沈棋,范宇,金杰. 双参数MRI改良PI-RADS评分4分和5分病灶的最大径对临床有意义前列腺癌的预测效果[J]. 北京大学学报(医学版), 2024, 56(4): 567-574.
[3] 刘毅,袁昌巍,吴静云,沈棋,肖江喜,赵峥,王霄英,李学松,何志嵩,周利群. 靶向穿刺+6针系统穿刺对PI-RADS 5分患者的前列腺癌诊断效能[J]. 北京大学学报(医学版), 2023, 55(5): 812-817.
[4] 袁昌巍,李德润,李志华,刘毅,山刚志,李学松,周利群. 多参数磁共振成像中动态对比增强状态在诊断PI-RADS 4分前列腺癌中的应用[J]. 北京大学学报(医学版), 2023, 55(5): 838-842.
[5] 汪大伟,王华东,李利,尹欣,黄伟,郭继东,杨亚锋,刘义灏,郑扬. 自体下关节突骨块应用于骨质疏松患者腰椎椎间融合术的疗效分析[J]. 北京大学学报(医学版), 2023, 55(5): 899-909.
[6] 张心灵,林志禹,陈玉杰,董文芳,杨欣. 脊柱后路内固定术后切口愈合不良的整形外科治疗[J]. 北京大学学报(医学版), 2023, 55(5): 910-914.
[7] 林国中,谢京城,陈晓东,杨军. 成人原发性脊髓拴系综合征的分型及显微外科手术治疗[J]. 北京大学学报(医学版), 2023, 55(4): 641-645.
[8] 刘颖,霍然,徐慧敏,王筝,王涛,袁慧书. 磁共振血管壁成像评估颈动脉中重度狭窄患者斑块特征与脑血流灌注的相关性[J]. 北京大学学报(医学版), 2023, 55(4): 646-651.
[9] 傅强,高冠英,徐雁,林卓华,孙由静,崔立刚. 无症状髋关节前上盂唇撕裂超声与磁共振检查的对比研究[J]. 北京大学学报(医学版), 2023, 55(4): 665-669.
[10] 崔云鹏,施学东,刘佳,米川,王冰,潘元星,林云飞. 经皮椎弓根螺钉内固定联合可扩张管状牵开器下肿瘤切除治疗脊柱转移瘤的效果[J]. 北京大学学报(医学版), 2023, 55(3): 530-536.
[11] 马利加,胡攀攀,刘晓光. 脊柱转移癌伴软脊膜转移1例[J]. 北京大学学报(医学版), 2023, 55(3): 563-566.
[12] 郑丹枫,李君禹,李佳曦,张英爽,钟延丰,于淼. 青少年特发性脊柱侧凸椎旁肌的病理特征[J]. 北京大学学报(医学版), 2023, 55(2): 283-291.
[13] 叶珊,金萍萍,张楠,邬海博,石林,赵强,杨坤,袁慧书,樊东升. 肌萎缩侧索硬化患者认知功能改变与脑皮层厚度分析[J]. 北京大学学报(医学版), 2022, 54(6): 1158-1162.
[14] 蔡颖,万巧琴,蔡宪杰,高亚娟,韩鸿宾. 光生物调节加速脑组织间液引流及其机制[J]. 北京大学学报(医学版), 2022, 54(5): 1000-1005.
[15] 唐彦超,赵文奎,于淼,刘晓光. 无症状中国年轻人颈椎矢状位曲度正常值及其与全脊柱平衡的关系[J]. 北京大学学报(医学版), 2022, 54(4): 712-718.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!