[胎儿脑沟发育的三维超声研究]

Alves Cynthia Maria Soares, Araujo Júnior Edward, Nardozza Luciano Marcondes Machado, Oliveira Patrícia Soares de, Goldman Suzan Menasce, Ajzen Sérgio Aron, Moron Antonio Fernandes

Departamento de Obstetrícia, Universidade Federal de São Paulo, Brasil.

Rev Bras Ginecol Obstet. 2011 Mar;33(3).

PURPOSE

to assess the distance of the fetal cerebral fissures from the inner edge of the skull by three-dimensional ultrasonography (3DUS).

METHODS

this cross-sectional study included 80 women with normal pregnancies between 21st and 34th weeks. The distances between the Sylvian, parieto-occiptal, hippocampus and calcarine fissures and the internal surface of the fetal skull were measured. For the evaluation of the distance of the first three fissures, an axial three-dimensional scan was obtained (at the level of the lateral ventricles). To obtain the calcarine fissure measurement, a coronal scan was used (at the level of the occipital lobes). First degree regressions were performed to assess the correlation between fissure measurements and gestational age, using the determination coefficient (R²) for adjustment. The 5th, 50th and 95th percentiles were calculated for each fissure measurement. Pearson's correlation coefficient (r) was used to assess the correlation between fissure measurements and the biparietal diameter (BPD) and head circumference (HC).

RESULTS

all fissure measurements were linearly correlated with gestational age (Sylvian: R²=0.5; parieto-occiptal: R²= 0.7; hippocampus: R²= 0.3 and calcarine: R²= 0.3). Mean fissure measurement ranged from 7.0 to 14.0 mm, 15.9 to 28.7 mm, 15.4 to 25.4 mm and 15.7 to 24.8 mm for the Sylvian, parieto-occiptal, hippocampus and calcarine fissures, respectively. The Sylvian and parieto-occiptal fissure measurements had the highest correlations with the BPD (r=0.8 and 0.7, respectively) and HC (r=0.7 and 0.8, respectively).

CONCLUSION

the distance from the fetal cerebral fissures to the inner edge of the skull measured by 3DUS was positively correlated with gestational age.

目的

通过三维超声（3DUS）评估胎儿脑沟与颅骨内缘之间的距离。

方法

这项横断面研究纳入了80名孕周在21至34周之间的正常妊娠女性。测量了外侧裂、顶枕裂、海马裂和距状裂与胎儿颅骨内表面之间的距离。为评估前三个脑沟的距离，获取了轴位三维扫描图像（在侧脑室水平）。为测量距状裂，采用了冠状位扫描（在枕叶水平）。进行一级回归分析以评估脑沟测量值与孕周之间的相关性，并使用决定系数（R²）进行校正。计算每个脑沟测量值的第5、第50和第95百分位数。采用Pearson相关系数（r）评估脑沟测量值与双顶径（BPD）和头围（HC）之间的相关性。

结果

所有脑沟测量值均与孕周呈线性相关（外侧裂：R² = 0.5；顶枕裂：R² = 0.7；海马裂：R² = 0.3；距状裂：R² = 0.3）。外侧裂、顶枕裂、海马裂和距状裂的平均脑沟测量值分别为7.0至14.0毫米、15.9至28.7毫米、15.4至25.4毫米和15.7至24.8毫米。外侧裂和顶枕裂测量值与BPD（分别为r = 0.8和0.7）和HC（分别为r = 0.7和0.8）的相关性最高。