Bekker M N, Haak M C, Rekoert-Hollander M, Twisk J, Van Vugt J M G
Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands.
Ultrasound Obstet Gynecol. 2005 Mar;25(3):239-45. doi: 10.1002/uog.1831.
To investigate the presence and volume of jugular lymphatic sacs (JLS) in first-trimester fetuses with normal nuchal translucency thickness (NT) and in those with increased NT.
This was a prospective study of 26 fetuses with NT > 95(th) percentile, which were compared with 137 fetuses with normal NT. Following crown-rump length (CRL) and NT measurement the neck region of the fetus was studied by transvaginal ultrasound. The JLS presented as spheroidal translusencies in the anterolateral region of the neck.
The prevalence of JLS differed significantly between fetuses with enlarged NT and the control group (P < 0.0001). In the group of 26 fetuses with increased NT, 22 had clearly visible JLS. Chorionic villus sampling revealed aneuploidy in 10 and euploidy in 16 fetuses. In the control group two fetuses, with NT values of 2.8 mm and 2.9 mm, had JLS; pregnancy outcome was normal in both cases. Logistic regression analysis in the total study group showed that an increase in NT was associated with a greater probability of JLS being present (for NT = 3-3.5 mm, probability = 0.67; for NT > 3.5 mm, probability = 0.93). In fetuses with JLS, an increase in CRL was associated with a significant increase in right JLS volume (r = 0.51; P-value = 0.01) and a non-significant increase in left sac volume (r = 0.40; P-value = 0.09). Increase in NT was not associated with a significant increase in JLS volume.
There is a significant association between increased NT and the presence of JLS on first-trimester ultrasound. In our opinion, the pathophysiological explanation for increased NT lies in a disturbance in lymphangiogenesis.
研究孕早期颈部透明带厚度（NT）正常及NT增厚胎儿的颈淋巴囊（JLS）的存在情况及体积。
这是一项前瞻性研究，对26例NT>第95百分位数的胎儿与137例NT正常的胎儿进行比较。在测量头臀长（CRL）和NT后，经阴道超声研究胎儿的颈部区域。JLS表现为颈部前外侧区域的球形无回声区。
NT增大的胎儿与对照组JLS的发生率差异有统计学意义（P<0.0001）。在26例NT增厚的胎儿组中，22例可见明显的JLS。绒毛膜绒毛取样显示，10例胎儿为非整倍体，16例为整倍体。对照组中，2例NT值分别为2.8mm和2.9mm的胎儿有JLS；两例妊娠结局均正常。对整个研究组进行逻辑回归分析显示，NT增加与JLS出现的可能性增加相关（NT=3 - 3.5mm时，概率=0.67；NT>3.5mm时，概率=0.93）。在有JLS的胎儿中，CRL增加与右侧JLS体积显著增加相关（r=0.51；P值=0.01），与左侧囊体积增加无显著相关性（r=0.40；P值=0.09）。NT增加与JLS体积的显著增加无关。
孕早期超声检查显示NT增加与JLS的存在之间存在显著关联。我们认为，NT增加的病理生理学解释在于淋巴管生成的紊乱。
