中晚孕期胎儿胼胝体观察新方法:二维颅脑横切面法
Two-dimensional cross-sectional method: a new method for observing fetal corpus callosum in the second and third trimesters
查看参考文献12篇
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文摘
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目的确定二维超声颅脑横切面上胼胝体观测切面及建立20周至足月正常胎儿横切面上胼胝体各径线参考值。方法选取2018年6月至2018年12月在南方医科大学附属深圳妇幼保健院行产前超声检查诊断无结构异常且因“计划外生育”或者母体宫颈机能不全在我院引产,其父母同意尸体解剖的10例20~30周单胎胎儿作为研究对象。采用三维自由解剖成像法和冰冻标本解剖法获取胼胝体的系列横切面/横断面。观察上述两种方法获取的系列横切/断面,总结各切面及对应断面的特征,得出横切面上胼胝体结构观察的稳定切面。选取同时期在南方医科大学附属深圳妇幼保健院常规产前超声检查无结构异常的670例孕20周至足月的单胎胎儿,在第一部分选定的胼胝体横切面进行胼胝体膝部前角、后角,压部前角、后角,胼胝体最大前后径,膝部左右径、前后径,压部左右径、前后径,体部前后径、左右径的测量。随机抽取40例胎儿行上述参数两测量者间的重复性检验;建立各孕周颅脑横切面上胼胝体各参数的正常参考值范围,绘制所测数据与孕周的散点图并行相关性分析,建立线性回归方程。结果三维自由解剖成像法和冰冻标本解剖法所获胼胝体3个横切面恒定显示相同的解剖结构。两观察者之间的重复性检验未见明显差异。各散点图显示正常胎儿胼胝体各参数测值与孕周呈正相关(r=0.232、0.343、0.284、0.182、0.913、0.895、0.748、0.787、0.736、0.684、0.734, P均< 0.01)。对各参数与孕周进行回归分析,回归方程分别为:Y=0.514X + 52.214,Y=0.785X + 42.897,Y=0.600X + 47.327,Y=0.436X + 53.056,Y=0.117X + 0.019,Y=0.070X-0.169,Y = 0.013X + 0.054,Y=0.065X + 0.180,Y=0.014X + 0.064,Y=0.047X + 0.547,Y=0.027X-0.116。结论基于三维自由解剖成像和冰冻标本解剖确定的系列切面相对固定,可作为胼胝体结构评估的切面。不同孕周胎儿胼胝体各径线正常参考值可作为产前评估胼胝体发育异常的参考依据。 |
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其他语种文摘
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Objective To determine the transverse sections of corpus callosum on twodimensional ultrasound and to establish the reference ranges for fetal corpus callosum dimensions on the transverse sections of normal foetus from 20 weeks to full term. Methods From June 2018 to December 2018, 10 singleton fetuses with no structural abnormalities diagnosed by prenatal ultrasound were selected as study subjects at Shenzhen Maternal and Child Health Hospital, whose parents consented to autopsy at 20- 30 weeks of pregnancy due to inevitable abortion for ″cervical incompetence″ or ″unplanned birth″. A series of transverse sections obtained by three-dimensional oblique technique and frozen autopsy specimens were observed, and the characteristics of each section were summarized. The stable sections of corpus callosum on the transverse section were selected. From June 2018 to December 2018, 670 singleton pregnant women underwent routine ultrasound examination at the Ultrasound Department of our hospital. The corpus callosum diameters including the longest diameter of the corpus callosum, left to right genu diameter, anterior to posterior genu diameter, left to right splenium diameter, anterior to posterior splenium diameter, left to right body diameter, and anterior to posterior body diameter, and the angle of genu and splenium were measured at the cross-sectional plane mentioned above. Forty fetuses were randomly sampled and tested for repeatability between the two measurements. The normal reference ranges of the parameters of corpus callosum on the transverse section of the brain of each gestational week were established, and the correlation between the measured data and the scatter plot of gestational week was analyzed in parallel to establish regression equations. Results Three cross sections of corpus callosum obtained by the two different methods showed the same anatomical structures. There was no significant difference in the repeatability test between two observers. The scatter plots showed that the parameters of normal fetal corpus callosum were positively correlated with gestational age (r=0.232, 0.343, 0.284, 0.182, 0.913, 0.895, 0.748, 0.787, 0.736, 0.684, and 0.734, respectively, P < 0.01). The regression equations were Y=0.514X + 52.214, Y=0.785X + 42.897, Y=0.600X+47.327, Y=0.436X+53.056, Y=0.117X+0.019, Y=0.070X-0.169, Y=0.013X+0.054, Y=0.065X+ 0.180, Y=0.014X + 0.064, Y=0.047X + 0.547, and Y=0.027X-0.116, respectively. Conclusions The serial transverse sections based on 3D oblique technique and frozen autopsy specimens are relatively stable and can be used to evaluate the structure of corpus callosum. The reference charts for normal fetal corpus callosum of different gestational ages may be useful for prenatal evaluation of congenital corpus callosum anomalies. |
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来源
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中华医学超声杂志（电子版）
,2019,16(7):495-503 【核心库】
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DOI
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10.3877/cma.j.issn.1672-6448.2019.07.003
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关键词
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横切面
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胎儿
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胼胝体
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中晚孕期
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参考值
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地址
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南方医科大学附属深圳妇幼保健院超声科, 518028
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语种
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中文 |
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文献类型
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研究性论文 |
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ISSN
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1672-6448 |
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学科
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临床医学;妇产科学 |
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基金
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国家重点研发计划
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国家自然科学基金
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广东省深圳市科技计划项目
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文献收藏号
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CSCD:6649454
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