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

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