Ultrasonic diagnosis and outcome of 50 fetuses with posterior fossa abnormalities

doi:10.3877/cma.j.issn.1672-6448.2018.08.006

Abstract

Abstract:

Objective

To analyze the ultrasound diagnostic accuracy and postnatal outcome of fetal posterior fossa abnormalities.

Methods

The ultrasonic image features of 50 fetuses with posterior fossa abnormalities between Aug. 2015 to Mar. 2018 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University were retrospectively summarized and compared with their brain magnetic resonance imaging (MRI) findings and the results of checkups and follow-ups after birth. And the prenatal diagnostic accuracy of two dimensional (2D) and three dimensional (3D) ultrasound was analyzed.

Results

Among 50 cases with posterior fossa abnormalities, prenatal 3D ultrasound diagnosed 8 cases of Dandy-Walker malformation, 8 cases of vermian hypoplasia, 6 cases of Blake's pouch cyst, 5 cases of cerebellar hypoplasia, 9 cases of posterior fossa arachnoid cyst, 13 cases of isolated mega cisterna magna and 1 case of vermian abnormal morphology. Among them, fetal brain MRI were performed in 26 cases, and the results of 23 cases were consistent with the prenatal 3D ultrasound results. In the rest 2 inconsistent cases, the fetal brain MRI added supplementary diagnosis in 1 case. Postnatal outcome: after the performances of ultrasound and fetal MRI, 24/50 patients chose intrauterine termination of pregnancy (5 cases were lost), and 26/50 patients chose to continue with pregnancy (I case of vermian hypoplasia and cerebellar hypoplasia, 4 cases of Blake′s pouch cyst, 7 cases of posterior fossa arachnoid cyst, 13 cases of isolated mega cisteran magna). Among the 26 cases, one fetus was diagnosed as Joubert Syndrome after birth, the other 25 fetuses were of good prognosis. The diagnostic accuracy: compared with fetal brain MRI and the results of checkups and follow-ups after birth, the diagnostic accuracy of 2D and 3D was 62.2% (28/45) and 88.9% (40/45), respectively.

Conclusions

Different posterior fossa abnormalities (eg. Dandy-Walker malformation, vermian hypoplasia and Blake's pouch cyst) have similar prenatal 2D ultrasonic characteristics. Prenatal 3D ultrasound is of great significance in the classification and diagnosis of posterior fossa abnormalities.

Key words: Ultrasonography, prenatal, Fetus, Abnormal posterior fossa, Three-dimensional ultrasound

Cuixia Guo, Qingqing Wu, Li Wang, Lijuan Sun, Xinlian Wang. Ultrasonic diagnosis and outcome of 50 fetuses with posterior fossa abnormalities[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(08): 593-599.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.08.006

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I08/593

Figures/Tables 4

References 18

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检查方法	检查例数	Dandy-Walker畸形（8例）	小脑蚓部发育不良（8例）	Blake′s陷窝囊肿（6例）	小脑发育不良（5例）	颅后窝蛛网膜囊肿（9例）
二维超声	50	13^a	5^b	2^b	5	5^a
三维超声	50	8	8	6	5	9
磁共振	26	7^b	5^b	2^b	3^b	4^b
检查方法	检查例数	单纯小脑延髓池增宽（13例）	小脑蚓部形态异常（1例）	诊断不确定（6例）	妊娠结局
检查方法	检查例数	单纯小脑延髓池增宽（13例）	小脑蚓部形态异常（1例）	诊断不确定（6例）	存活	引产
二维超声	50	13	1	6	26	24
三维超声	50	13	1	0	26	24
磁共振	26	4^b	1	0	8	18

检查方法	检查例数	Dandy-Walker畸形（8例）	小脑蚓部发育不良（8例）	Blake′s陷窝囊肿（6例）	小脑发育不良（5例）	颅后窝蛛网膜囊肿（9例）
二维超声	50	13^a	5^b	2^b	5	5^a
三维超声	50	8	8	6	5	9
磁共振	26	7^b	5^b	2^b	3^b	4^b
检查方法	检查例数	单纯小脑延髓池增宽（13例）	小脑蚓部形态异常（1例）	诊断不确定（6例）	妊娠结局
检查方法	检查例数	单纯小脑延髓池增宽（13例）	小脑蚓部形态异常（1例）	诊断不确定（6例）	存活	引产
二维超声	50	13	1	6	26	24
三维超声	50	13	1	0	26	24
磁共振	26	4^b	1	0	8	18

检查方法	随访例数^a	超声提示诊断	与产后诊断符合率（%）
二维超声	45	28^bc	56.0
三维超声	45	40	88.9

检查方法	随访例数^a	超声提示诊断	与产后诊断符合率（%）
二维超声	45	28^bc	56.0
三维超声	45	40	88.9

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