Centro Gutenberg, Prenatal Diagnosis and Ultrasound Unit, Málaga, Spain.
Ultrasound Obstet Gynecol. 2010 Dec;36(6):693-9. doi: 10.1002/uog.7660. Epub 2010 Apr 15.
To establish normal reference ranges for the depth of the insula and Sylvian (SF), parieto-occipital (POF) and calcarine (CF) fissures on prenatal ultrasound between 19 and 30 weeks of gestation.
This was a prospective study of 15 consecutive normal fetuses per gestational week between 19 + 0 and 30 + 6 weeks. We measured the depth of the insula and SF in a standard transventricular axial plane of the fetal head; the depth of the POF in a plane above and parallel to that used for the insula; and the depth of the CF in a coronal view of the posterior fossa. All measurements were done transabdominally during the routine second- or third-trimester examination. Reproducibility for each of the parameters was assessed by two operators using stored images from 30 cases.
The depth of the four structures increased with increasing gestational age. The insula and SF could be seen in all cases from 19 weeks onwards, while the POF and CF could be identified in 93.3% and 6.6% of cases, respectively, at 19 weeks. From 20 weeks onwards, the POF could be seen in all examinations, as could the CF from 24 weeks. Intra- and interobserver reproducibility analysis showed good results.
Assessment of the insula, SF, POF and CF is feasible during prenatal ultrasound examination using standard views of the fetal head. Since the normal ranges increase with gestational age, they could be used to estimate brain development. It is possible that this assessment might be incorporated into the neurosonogram to identify fetuses at risk of maturation disorders or as a complement to other standard evaluations.
建立 19 至 30 孕周产前超声下岛叶和外侧裂（SF）、顶枕裂（POF）和距状裂（CF）深度的正常参考范围。
这是一项 15 例连续正常胎儿的前瞻性研究，每个孕周为 19+0 至 30+6 周。我们在胎儿头部标准经脑室轴位平面测量岛叶和 SF 的深度；在与岛叶平行的上方平面测量 POF 的深度；在后颅窝冠状视图中测量 CF 的深度。所有测量均在常规的中晚期检查过程中经腹部进行。两名操作人员使用 30 例存储的图像评估每个参数的可重复性。
这四种结构的深度随着胎龄的增加而增加。从 19 周开始，所有病例均可观察到岛叶和 SF，而 POF 和 CF 分别可在 19 周的 93.3%和 6.6%的病例中识别。从 20 周开始，所有检查均可观察到 POF，而从 24 周开始，也可观察到 CF。观察者内和观察者间的可重复性分析显示出良好的结果。
使用胎儿头部的标准视图，在产前超声检查中评估岛叶、SF、POF 和 CF 是可行的。由于正常范围随胎龄增加而增加，因此它们可用于估计大脑发育情况。这种评估可能被纳入神经超声检查以识别有成熟障碍风险的胎儿，或作为其他标准评估的补充。
