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目的探讨产前常规超声检查对胎儿脑中线结构异常的临床应用价值。方法回顾性分析经常规超声检查怀疑有脑中线结构异常的胎儿178例,孕妇年龄19~43岁,平均年龄30.7岁,孕周14~38周。平均孕周28.4周。所有胎儿均经腹扫查,应用二维或三维超声扫查模式,总结并归纳其声像图特征。超声怀疑有脑中线结构异常的胎儿可行MRI检查或染色体检查,经生后随访或尸检证实超声检查结果。计算超声和MRI诊断胎儿脑中线结构异常的阳性预测值,采用卡方检验进行统计学分析。结果产前超声诊断胎儿脑中线结构异常178例,其中前脑无裂畸形27例,胼胝体发育不全53例,单纯透明隔腔缺如2例,Dandy-Walker畸形9例,小脑蚓部发育不良14例,巨大枕大池73例。178例胎儿失访9例,经生后随访或尸检证实的169例胎儿中,真阳性数为145例;178例胎儿中共有73例接受MRI检查,阳性60例,其中真阳性数为53例;超声和MRI诊断胎儿脑中线结构异常的阳性预测值分别为85.8%及88.3%,二者间差异无统计学意义(P>0.05)。结论超声检查安全有效,方便省时,对胎儿脑中线结构异常确诊率较高,是产前筛查胎儿脑中线结构异常的可靠方法。
Objective To investigate the clinical value of routine prenatal ultrasound in detecting fetal brain midline abnormalities. Methods A retrospective analysis of 178 cases of suspected fetal brain midline abnormalities by conventional ultrasound examination, pregnant women aged 19 to 43 years, mean age 30.7 years, gestational age 14 to 38 weeks. The average gestational age is 28.4 weeks. All fetuses were examined by abdominal scan, the application of two-dimensional or three-dimensional ultrasound scan mode, summarize and summarize the sonographic features. Ultrasound suspected of abnormal brain structure of the fetus feasible MRI examination or chromosome examination, confirmed by postnatal follow-up or autopsy ultrasound results. The positive predictive value of ultrasound and MRI in diagnosing fetal brain midline structure was calculated and analyzed by chi-square test. Results The prenatal ultrasound diagnosis of fetal brain midline structure abnormalities in 178 cases, including 27 cases of anterior segment of the brain without rupture, corpus callosum hypoplasia in 53 cases, simple lack of transparent compartment in 2 cases, 9 cases of Dandy-Walker malformation, cerebellar vermis dysplasia 14 For example, a huge pillow in 73 cases. Among the 178 fetuses, 178 cases were fetched with MRI, and the positive number was found in 53 cases. The positive number of positive fetuses was 53 The positive predictive value of ultrasound and MRI in diagnosing fetal brain midline structure were 85.8% and 88.3%, respectively, with no significant difference (P> 0.05). Conclusion Ultrasound examination is safe and effective, convenient and time-saving, and has a high diagnosis rate of abnormal midline structure of fetus, which is a reliable method for prenatal screening of fetal brain midline structure abnormalities.