Iliescu D, Comănescu A, Antsaklis P, Tudorache Stefania, Ghiluşi Mirela, Comănescu Violeta, Paulescu Daniela, Ceauşu Iuliana, Antsaklis A, Novac Liliana, Cernea N
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania.
Rom J Morphol Embryol. 2011;52(3):809-17.
Morphological investigation of the central nervous system (CNS) in fetuses with positive markers for open spina bifida (OSB) detection, visualized by ultrasound during the first trimester of pregnancy.
Data from fetuses that underwent routine first trimester ultrasound scan in our center during September 2007-March 2011 and presented abnormal aspects of the fourth ventricle, also referred as intracranial translucency (IT), provided the morphological support to evaluate CNS features. A neuro-histological study of posterior cerebral fossa illustrated anatomical features of the structures involved in the sonographic first trimester detection of neural tube defects.
Abnormal IT aspects were found in OSB cases examined in the first trimester, but also in other severe cerebral abnormalities. Brain stem antero-posterior diameter (BS) and brain stem to occipital bone (BSOB) ratio may be more specific for OSB detection. Correlations between histological aspects of posterior brain fossa and ultrasound standard assessment have been made; highlighting the anatomical features involved by the new techniques developed for OSB early detection.
Preliminary results show that modern sonographic protocols are capable to detect abnormalities in the morphometry of the posterior brain. First trimester fourth ventricle abnormalities should be followed by careful CNS evaluation because are likely to appear in OSB affected fetuses, but also in other CNS severe anomalies; in such cases, normal BS and BSOB ratio may serve as indirect argument for spine integrity, if specificity is confirmed in large series of fetuses.
对妊娠早期超声检查显示开放性脊柱裂（OSB）检测标志物呈阳性的胎儿中枢神经系统（CNS）进行形态学研究。
收集2007年9月至2011年3月在本中心接受常规妊娠早期超声扫描且第四脑室存在异常表现（也称为颅内透明层，IT）的胎儿数据，为评估中枢神经系统特征提供形态学依据。对后颅窝进行神经组织学研究，以阐明妊娠早期超声检测神经管缺陷所涉及结构的解剖特征。
在妊娠早期检查的开放性脊柱裂病例中发现了异常的颅内透明层表现，但在其他严重脑异常中也有发现。脑干前后径（BS）和脑干与枕骨（BSOB）比值可能对开放性脊柱裂的检测更具特异性。已建立后颅窝组织学表现与超声标准评估之间的相关性；突出了为开放性脊柱裂早期检测所开发新技术涉及的解剖特征。
初步结果表明，现代超声检查方案能够检测后脑部形态测量的异常。妊娠早期第四脑室异常应随后进行仔细的中枢神经系统评估，因为其可能出现在开放性脊柱裂受累胎儿中，也可能出现在其他中枢神经系统严重异常中；在这种情况下，如果在大量胎儿中得到证实，正常的脑干前后径和脑干与枕骨比值可作为脊柱完整性的间接证据。
