胎儿中枢神经系统产前超声检查专家共识（2020）

doi:10.3877/cma.j.issn.1672-6448.2021.05.001

中华医学超声杂志（电子版） ›› 2021, Vol. 18 ›› Issue (05) : 433 -443. doi: 10.3877/cma.j.issn.1672-6448.2021.05.001

所属专题：总编推荐；产前超声；文献；指南共识；妇产科超声；

专家共识

胎儿中枢神经系统产前超声检查专家共识（2020）

杨帆¹, 李胜利², 罗红³^,^†(

), 朱军⁴, 彭诗云³

^1. 610041　成都，四川大学华西第二医院超声科；610041　成都，四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室；610051　成都市成华区妇幼保健院
^2. 518000　南方医科大学附属深圳妇幼保健院超声科
^3. 610041　成都，四川大学华西第二医院超声科；610041　成都，四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室
^4. 610041　成都，四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室；610041　成都，四川大学华西第二医院全国妇幼卫生监测办公室/中国出生缺陷检测中心

收稿日期:2020-08-21 出版日期:2021-05-01
通信作者: 罗红
基金资助:
国家重点研发计划“基于孕前-产前-生后全链条的出生缺陷综合防控规范化体系研究”(2018YFC1002200); “西部地区出生缺陷产前筛查及诊断应用示范研究”(2017YFC0113905)

Expert consensus on prenatal ultrasound examination of the fetal central nervous system (2020)

Fan Yang¹, Shengli Li², Hong Luo³()

Received:2020-08-21 Published:2021-05-01
Corresponding author: Hong Luo

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引用本文：

杨帆, 李胜利, 罗红, 朱军, 彭诗云. 胎儿中枢神经系统产前超声检查专家共识（2020）[J]. 中华医学超声杂志（电子版）, 2021, 18(05): 433-443.

Fan Yang, Shengli Li, Hong Luo. Expert consensus on prenatal ultrasound examination of the fetal central nervous system (2020)[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(05): 433-443.

图1 早孕期胎头横切面。图a示胎儿头部横切面显示未完全骨化的颅骨强回声环、脑中线和呈“蝴蝶状”的脉络丛；图b为早孕期胎头横切面的示意图

图2 胎儿头部丘脑水平横切面。图a为丘脑水平横切面超声扫查模式图；图b为丘脑水平横切面声像图显示丘脑、脑中线、透明隔腔、第三脑室、胼胝体、前角、尾状核头部、脉络丛、大脑外侧裂、大脑实质；图c为胎儿头部丘脑水平横切面的示意图

图3 胎儿头部丘脑水平横切面测量双顶径和头围

图4 胎儿头部侧脑室水平横切面。图a为侧脑室水平横切面超声扫查模式图；图b为侧脑室水平横切面声像图显示侧脑室后角与前角、丘脑、侧脑室体部、透明隔腔、尾状核头部、脉络丛、大脑镰、大脑外侧裂、大脑实质；图c为胎儿头部侧脑室水平横切面的示意图

图5 胎儿侧脑室的测量。图a为胎儿侧脑室测量的声像图；图b为胎儿侧脑室测量的示意图

图6 胎儿头部小脑水平横切面。图a为小脑水平横切面超声扫查模式图；图b为小脑水平横切面声像图显示小脑半球、小脑蚓部、小脑延髓池、大脑脚、丘脑、第三脑室、透明隔腔、前角、大脑外侧裂、胼胝体；图c为胎儿头部小脑水平横切面的示意图

图7 胎儿小脑水平横切面测量小脑横径和小脑延髓池深度

图8 胎儿头部额叶冠状切面。图a为额叶冠状切面超声扫查模式图；图b为额叶冠状切面声像图显示脑中线、大脑额叶、前角前方稍高回声的脑白质；图c为胎儿头部额叶冠状切面的示意图

图9 胎儿头部侧脑室前角冠状切面。图a为侧脑室前角冠状切面超声扫查模式图；图b为侧脑室前角冠状切面声像图显示侧脑室前角、尾状核头部、胼胝体、透明隔腔、大脑颞叶皮质、外侧裂；图c为胎儿头部侧脑室前角冠状切面的示意图

图10 胎儿头部侧脑室体部冠状切面。图a为侧脑室体部冠状切面超声扫查模式图；图b为侧脑室体部冠状切面声像图显示丘脑、胼胝体、透明隔腔、外侧裂、脑干、大脑顶叶、尾状核头部、侧脑室体部、侧脑室下角、第三脑室、大脑颞叶；图c为胎儿头部侧脑室体部冠状切面的示意图

图11 胎儿头部小脑冠状切面。图a为小脑冠状切面超声扫查模式图；图b为小脑冠状切面声像图显示小脑半球及小脑蚓部、小脑延髓池、胼胝体、透明隔腔、丘脑、大脑颞叶、尾状核头部、前角、大脑外侧裂；图c为胎儿头部小脑冠状切面的示意图

图12 胎儿头部侧脑室三角区冠状切面。图a为侧脑室三角区冠状切面超声扫查模式图；图b为侧脑室三角区冠状切面声像图显示侧脑室三角区及其内部的脉络丛、脑室周围白质、大脑顶叶、大脑枕叶、大脑镰、后角；图c为胎儿头部侧脑室三角区冠状切面的示意图

图13 胎儿头部枕叶冠状切面。图a为枕叶冠状切面超声扫查模式图；图b为枕叶冠状切面声像图显示枕叶、顶叶及深部侧脑室后角周围的脑白质；图c为胎儿头部枕叶冠状切面的示意图

图14 早孕期胎头正中矢状切面。图a为早孕期胎儿正中矢状切面显示鼻尖、鼻骨、丘脑、第三脑室、中央导水管、第四脑室、脑干、小脑延髓池、小脑蚓部处、中脑、延髓、脊髓、脉络丛；图b为早孕期胎头正中矢状切面的示意图

图15 胎儿头部正中矢状切面。图a为正中矢状切面超声扫查模式图；图b为正中矢状切面声像图显示胼胝体、透明隔腔、第三脑室、第四脑室、小脑蚓部、小脑延髓池；图c为胎儿头部正中矢状切面的示意图

图16 胎儿头部旁正中矢状切面。图a为旁正中矢状切面超声扫查模式图；图b为旁正中矢状切面声像图显示侧脑室前角、尾状核丘脑沟、尾状核头部、丘脑、大脑额叶、大脑颞叶、顶叶、枕叶、侧脑室体部、后角和颞角、脉络丛、脑白质；图c为胎儿头部旁正中矢状切面的示意图

图17 胎儿头部大脑半球矢状切面。图a为大脑半球矢状切面超声扫查模式图；图b为大脑半球矢状切面声像图显示大脑额叶、顶叶、枕叶、颞叶、岛叶、大脑外侧裂和脑白质结构；图c为胎儿头部大脑半球矢状切面的示意图

图18 中孕期胎儿脊柱矢状切面。图a为胎儿脊柱旁正中矢状切面显示从头颈部至骶尾部的脊柱椎体和椎弓；图b为胎儿脊柱正中矢状切面显示脊髓圆锥（箭头）位于第二腰椎水平

图19 早孕期胎儿脊柱旁正中矢状切面。早孕期脊柱旁正中矢状切面显示胎儿骨化的脊柱排列规整连续、自然弯曲；颈段脊柱还未骨化（箭头）；皮肤回声未见中断

图20 胎儿脊柱冠状切面。图a为显示颈椎、胸椎的椎体骨化中心；图b为显示腰椎、骶椎的椎体骨化中心

图21 胎儿不同节段脊柱的横切面。图a为第一颈椎；图b为胸椎；图c为腰椎；图d为骶椎

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