Takeuchi H
Department of Obstetrics and Genecology, Juntendo University Urayasu Hospital, Chiba.
No To Hattatsu. 1991 Mar;23(2):183-8.
Among fetal anomalies, the rate of the central nervous system (CNS) abnormality is high, and almost all cases are wanted to diagnose prenatally for the improvement of their prognosis. For instance, anencephaly should be detected for its lethal prognosis. Hydrocephalus has a certain possibility for intrauterine treatment. Spina bifida should be found in utero for the immediate operation after birth. At present, most of these major anomalies of CNS can be successfully screened or diagnosed by using ultrasonography. Brain anomalies such as hydrocephalus, Dandy-Walker anomaly and holoprosencephaly show characteristic dilatation of ventricles, which can be easily found in the routine screening ultrasonography from the beginning of the second trimester of gestation. Ultrasonographic detection of neural tube defects such as anencephaly and spina bifida is not difficult in utero. Thus it is possible to diagnose the most of CNS anomalies by using prenatal ultrasound in the early stage of gestation now. Recent advances of ultrasonography, particularly the development of transvaginal technique have contributed to the earlier diagnosis of CNS anomaly even in the first trimester of gestation.
在胎儿畸形中，中枢神经系统（CNS）异常的发生率较高，几乎所有病例都希望进行产前诊断以改善其预后。例如，无脑儿因其致命的预后应被检测出来。脑积水有一定的宫内治疗可能性。脊柱裂应在子宫内被发现，以便出生后立即进行手术。目前，这些中枢神经系统的大多数主要畸形都可以通过超声检查成功筛查或诊断出来。诸如脑积水、Dandy-Walker畸形和前脑无裂畸形等脑畸形表现出脑室的特征性扩张，在妊娠中期开始的常规筛查超声检查中很容易发现。在子宫内超声检测神经管缺陷如无脑儿和脊柱裂并不困难。因此，现在在妊娠早期使用产前超声有可能诊断出大多数中枢神经系统异常。超声检查的最新进展，特别是经阴道技术的发展，有助于即使在妊娠早期也能更早地诊断中枢神经系统异常。
