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目的探讨胎儿小脑延髓池的产前超声测量对于评价胎儿颅后窝畸形的价值。方法回顾性地分析2007年1月至2009年1月我院诊查的186例宫内单胎妊娠超声测量胎儿小脑延髓池声像图资料,分组进行小脑延髓池前后径(AnteroposteriorDiameterS,APD)测量,并对新生儿出生后进行随访,分析颅后窝积液胎儿的妊娠结局。结果121例患者的胎儿APD<10mm,65例患者的胎儿小脑延髓池APD≥10mm。65例胎儿APD>10mm的病例中,14例胎儿畸形,占21.5%(14/65)。以APD≥13mm作为超声诊断胎儿颅后窝积液的标准筛查胎儿颅后窝畸形,其特异度(71.8%)和阳性预测值(29%)较APD≥10mm的标准分别提高了10%和7.5%,尤其是假阳性率明显降低,其假阳性率为18.2%。结论产前超声测量胎儿小脑延髓池对于发现胎儿颅后窝畸形有一定的价值,以胎儿小脑延髓池APD≥13mm作为超声诊断胎儿颅后窝积液的标准来筛查胎儿颅后窝畸形比较适合。
Objective To investigate the value of prenatal ultrasound measurement of fetal cerebellomedullary cistern for the evaluation of fetal posterior fossa deformity. Methods A retrospective analysis of 186 cases of unilateral fetal ultrasound measurement of fetal cisterna magna in January 2007 to January 2009 in our hospital was performed to investigate the anteroposterior diameter meter (APD) , And newborns were followed up after birth to analyze the fetal outcome of the fetus of hydronephrosis. Results 121 patients with fetal APD <10mm, 65 patients with fetal cerebellar cistern APD ≥ 10mm. Fourteen cases of fetal malformations accounted for 21.5% (14/65) in 65 cases of APD> 10 mm. With APD≥13mm as the standard diagnostic ultrasound for fetal posterior fossa, the specificity (71.8%) and positive predictive value (29%) were higher than those of APD≥10mm by 10% and 7.5%, especially the false positive rate was significantly reduced, the false positive rate was 18.2%. Conclusion Prenatal ultrasound measurement of fetal cerebellar cistern lamellae for the discovery of fetal posterior fossa deformity has some value to the fetal cerebellar cistern APD ≥ 13mm as the ultrasound diagnosis of fetal posterior fossa effusion to screen the standard of fetus fetal posterior fossa deformity more appropriate .