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目的探讨超声检测11~13~(+6)周胎儿的颅内透明层(intracranial translucency,IT)厚度对早期诊断开放性脊柱裂的价值。方法对怀孕11~13~(+6)周的孕妇进行胎儿常规超声检查(ultrasonography,US),通过在面部正中失状切面对胎儿颈后透明层(nuchal translucency,NT)的厚度测量和鼻骨观察的同时,测量位于脑干和第四脑室脉络丛之间的颅内半透明层(IT)厚度。同时,对250个正常胎儿和12个有开放性脊柱裂的胎儿回顾性进行颅内半透明层测量和评估,以产后或引产后结果为金标准确定有无开放性脊柱裂。结果从正常胎儿的IT可见,而且其前后径在1.5 mm(头臀径45 mm)~2.5 mm(头臀径84 mm)之间。而这12个有开放性脊柱裂的胎儿,其脑室受压,颅后窝颅内结构移位,而且无法清晰显示颅内透明层。结论常规对怀孕早期胎儿面部正中失状的观察不仅有利于筛查染色体缺陷,还可以早期发现胎儿开放性脊柱裂。
Objective To investigate the value of intracranial translucency (IT) thickness of fetus from 11 ~ 13 ~ (+6) weeks fetuses in the early diagnosis of open spina bifida. Methods Ultrasonography (US) was performed on pregnant women with 11 ~ 13 ~ (+6) weeks of pregnancy. The thickness of the fetal nuchal translucency (NT) At the same time of observation, the thickness of the intracranial translucent layer (IT) located between the brainstem and the fourth ventricle choroid plexus was measured. At the same time, intracranial translumenal layer was measured retrospectively in 250 normal fetuses and 12 open-fissured fetuses. The post-natal or post-labor outcome was the gold standard to determine the presence or absence of open spina bifida. The results were visualized from the normal fetus IT, with an anteroposterior diameter of 1.5 mm (head to hip diameter 45 mm) to 2.5 mm (head to hip diameter 84 mm). The 12 open spina bifida fetus, its ventricular compression, cranial fossa intracranial structure shift, and can not clearly show the intracranial clear layer. Conclusion Conventional observation of midface loss in fetus during early pregnancy not only helps to screen for chromosomal defects, but also early detection of open spina bifida.