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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2022, Vol. 19 ›› Issue (09) : 882 -887. doi: 10.3877/cma.j.issn.1672-6448.2022.09.003

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实践与规范

早孕期胎儿中枢神经系统超声规范化筛查
栗河舟1,†(), 张恒静1, 王铭1   
  1. 1. 450052　郑州大学第三附属医院超声科
  • 收稿日期:2022-05-08 出版日期:2022-09-01
  • 通信作者: 栗河舟

Standardized ultrasound screening of fetal central nervous system in early pregnancy

Hezhou Li1(), Hengjing Zhang1, Ming Wang1   

  • Received:2022-05-08 Published:2022-09-01
  • Corresponding author: Hezhou Li
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栗河舟, 张恒静, 王铭. 早孕期胎儿中枢神经系统超声规范化筛查[J]. 中华医学超声杂志（电子版）, 2022, 19(09): 882-887.

Hezhou Li, Hengjing Zhang, Ming Wang. Standardized ultrasound screening of fetal central nervous system in early pregnancy[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(09): 882-887.

图1 早孕期胎儿侧脑室水平横切面。显示中线处的大脑镰把左右大脑半球分开，呈“蝴蝶征”的脉络丛，侧脑室内脑脊液（*所示），还可显示发育中的薄层脑实质呈条状无回声（长箭头所示），其外为高回声脑膜，内衬高回声室管膜注：LV为侧脑室；CP为脉络丛；Falx为大脑镰
图2 早孕期胎儿丘脑水平横切面。显示丘脑、第三脑室、中脑导水管及大脑脚；*示侧脑室内脑脊液注：T为丘脑；TV为第三脑室；AOS为中脑导水管；P为大脑脚；Falx为大脑镰；CP为脉络丛
图3 胎儿丘脑水平横切面测量中脑导水管后缘至枕骨前缘的距离（黄色双箭头）
图4 正常胎儿、开放性脊柱裂胎儿丘脑水平横切面及引产后图片。图a示正常胎儿丘脑横切面中脑（黄色虚线）与枕骨之间有间隙，中脑导水管与枕骨之间有一定距离，两侧丘脑和大脑脚外侧缘切线所成夹角为锐角（黄色箭头所示）；图b为开放性脊柱裂胎儿丘脑横切面中脑（红色虚线）与枕骨（白色箭头）邻接，形成“碰撞征”，中脑导水管（图中星号所示）到枕骨前缘的距离缩短，两侧丘脑和大脑脚外侧缘切线接近平行（红色箭头所示）；图c为胎儿引产后标本，证实为开放性脊柱裂注：AOS为中脑导水管；OB为枕骨
图5 早孕期胎儿颅后窝水平斜横切面。显示丘脑、第四脑室、脉络丛、发育中的小脑和颅后窝池注：T为丘脑；FV为第四脑室；CP为第四脑室脉络丛；CM为颅后窝池；CH为小脑半球
图6 早孕期胎儿颅脑正中矢状切面。显示鼻骨、丘脑、脑干、第四脑室（颅内透明层）、第四脑室脉络丛、颅后窝池注：NB为鼻骨；T为丘脑；P为脑桥；MO为延髓；FV为第四脑室；CM为颅后窝池；CP为第四脑室脉络丛；NT为颈后透明层
图7 胎儿颅脑正中矢状切面测量额上颌角注：FMF为额上颌角
图8 正常胎儿和开放性脊柱裂胎儿的颅脑正中矢状切面对比图。图a示正常胎儿BS（黄色双向箭头）＜BSOB（红色双向箭头），两者比值＜1；图b示开放性脊柱裂胎儿BS（黄色双向箭头）＞BSOB（红色双向箭头），两者比值＞1注：BS为脑干前后经（黄色双向箭头）；BSOB为脑干-枕骨间距离（红色双向箭头）
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