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目的观察和探讨经腹三维超声容积对比成像联合核磁共振成像(MRI)对胎儿小脑蚓部发育异常的诊断价值。方法选取2015年1月—2016年12月产前超声检查的3 659例孕妇为研究对象,产前超声检查、系统胎儿检查显示疑似小脑蚓部发育异常20例,从剩余正常胎儿中抽取30例为对照组,均接受经腹三维超声容积对比成像联合MRI检查,观察胎儿小脑蚓部发育正常、异常声像图表现,测量并比较正常与异常胎儿平均BT、BV。结果 20例疑似小脑蚓部发育异常胎儿经腹三维超声容积对比成像联合核磁共振成像检查显示单纯后颅窝池增宽9例,Dandy-Walker变异5例,Blake’s囊肿4例,Dandy-Walker畸形2例,以上病例均经本院引产或生产后追踪随访证实,与结果一致。Dandy-Walker变异、Blake’s囊肿、Dandy-Walker畸形胎儿平均BV、BT均显著大于对照组(P<0.05),但单纯后颅窝池增宽与对照组比较差异无统计学意义(P>0.05)。结论经腹三维超声容积对比成像联合核磁共振成像(MRI)在胎儿小脑蚓部发育异常诊断中有重要作用。
Objective To observe and discuss the diagnostic value of transabdominal three-dimensional ultrasound volume contrast imaging combined with magnetic resonance imaging (MRI) in the development of fetal cerebellar vermis. Methods A total of 3 659 pregnant women with prenatal ultrasound examination from January 2015 to December 2016 were enrolled in this study. Prenatal ultrasound and fetal examination showed that 20 cases were suspected of cerebellar vermis dysplasia. Thirty cases from the remaining normal fetuses The control group received three-dimensional transabdominal volume contrast imaging combined with MRI examination. The development of fetal cerebellar vermis was observed and the abnormal sonogram was observed. The average BT and BV of normal and abnormal fetuses were measured and compared. Results 20 cases of suspected cerebellar vermis dysplasia fetal transabdominal three-dimensional ultrasound volume contrast imaging combined with magnetic resonance imaging examination showed pure posterior fossa pool widening in 9 cases, Dandy-Walker mutation in 5 cases, Blake’s cyst in 4 cases, Dandy-Walker malformation 2 Cases, the above cases were induced by our hospital or post-production follow-up confirmed, with the results. The average BV and BT of Dandy-Walker mutation, Blake’s cyst and Dandy-Walker malformation fetus were significantly higher than those of the control group (P <0.05). However, there was no significant difference between the simple posterior fossa cell enlargement and the control group (P> 0.05) . Conclusion Transabdominal three-dimensional ultrasound volume contrast imaging combined with magnetic resonance imaging (MRI) in the development of fetal cerebellar vermis abnormalities play an important role.