整个孕期胎儿小脑半球轴周径和面积的列线图。

Nomograms of the axial fetal cerebellar hemisphere circumference and area throughout gestation.

作者信息

Sherer D M, Sokolovski M, Dalloul M, Pezzullo J C, Osho J A, Abulafia O

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Medical Center, Brooklyn, New York, USA.

Department of Pharmacology, Georgetown University, Washington, DC, USA.

出版信息

Ultrasound Obstet Gynecol. 2007 Jan;29(1):32-37. doi: 10.1002/uog.3879.

DOI:10.1002/uog.3879

PMID:17171631

Abstract

OBJECTIVE

The widely applied transcerebellar diameter (TCD) obtained at axial cranial imaging, measures the distance between the lateral aspects of the cerebellum and incorporates the width of the cerebellar vermis. Our objective was to create reference ranges of axial fetal cerebellar hemisphere circumference (CHC) and area (CHA), independent of the cerebellar vermis, throughout gestation.

METHODS

This cross-sectional study involved pregnant patients between 14 and 41 weeks of gestation. Inclusion criteria consisted of well-established dates (confirmed by early ultrasound), non-anomalous singleton fetuses and intact amniotic membranes. Sonographic measurements included biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), humerus length (HL), TCD, and estimated fetal weight (EFW). Values of axial fetal CHC and CHA were each calculated as the mean of three separate measurements. The 5th, 50th and 95th centiles were estimated at each week of gestational age (GA) by least-squares regression for the mean and standard deviation (SD) of the CHC and CHA as functions of GA. r2 and associated P-values for the relationships of CHC and CHA with other sonographic biometric measurements were calculated.

RESULTS

The study included 651 consecutive patients. All attempts at obtaining axial fetal CHC and CHA were successful. Mean maternal age was 27.3+/-6.7 years, median gravidity was 1 (range 1-16), and median parity was 1 (range 0-6). Mean CHC (cm) throughout gestation was modeled as -2.091+0.2563xGA (weeks) (SD=-0.075+0.0164xGA), and mean CHA (cm2) was modeled as 0.245-0.0765xGA+0.00506xGA2 (SD=1.167-0.1565xGA+0.006785xGA(2)-0.00008028xGA3). Fetal axial CHC and CHA correlated significantly and strongly with BPD, HC, AC, HL, FL, TCD and EFW (all R2 values were >or=0.95, and all P-values were <0.001).

CONCLUSION

Nomograms of axial fetal cerebellar hemisphere circumference and area throughout gestation, independent of the cerebellar vermis, have been provided.

摘要

目的

在轴向头颅成像中广泛应用的小脑横径（TCD）测量的是小脑外侧之间的距离，且纳入了小脑蚓部的宽度。我们的目的是建立整个孕期独立于小脑蚓部的胎儿轴向小脑半球周长（CHC）和面积（CHA）的参考范围。

方法

这项横断面研究纳入了妊娠14至41周的孕妇。纳入标准包括孕周确定（经早期超声确认）、单胎妊娠且无异常以及羊膜完整。超声测量包括双顶径（BPD）、头围（HC）、腹围（AC）、股骨长度（FL）、肱骨长度（HL）、TCD和估计胎儿体重（EFW）。胎儿轴向CHC和CHA的值均计算为三次独立测量的平均值。通过对CHC和CHA的平均值及标准差（SD）作为孕周（GA）的函数进行最小二乘回归，估计每个孕周的第5、第50和第95百分位数。计算CHC和CHA与其他超声生物测量指标之间关系的r2及相关P值。

结果

该研究纳入了651例连续患者。所有获取胎儿轴向CHC和CHA的尝试均成功。孕妇平均年龄为27.3±6.7岁，妊娠次数中位数为1（范围1 - 16），产次中位数为1（范围0 - 6）。整个孕期平均CHC（cm）的模型为 -2.091 + 0.2563×GA（周）（SD = -0.075 + 0.0164×GA），平均CHA（cm²）的模型为0.245 - 0.0765×GA + 0.00506×GA²（SD = 1.167 - 0.1565×GA + 0.006785×GA² - 0.00008028×GA³）。胎儿轴向CHC和CHA与BPD、HC、AC、HL、FL、TCD和EFW均显著且高度相关（所有R²值均≥0.95，所有P值均<0.001）。