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超声及胎儿磁共振成像对脊柱裂畸形的产前诊断:病例报告及文献复习

Prenatal diagnosis of split cord malformation by ultrasound and fetal magnetic resonance imaging: case report and review of the literature.

作者信息

Kutuk Mehmet Serdar, Ozgun Mahmut Tuncay, Tas Mustafa, Poyrazoglu Hatice Gamze, Yikilmaz Ali

机构信息

Faculty of Medicine, Department of Obstetrics and Gynecology, Gevher Nesibe Hospital, Erciyes University, 38039, Kayseri, Turkey.

出版信息

Childs Nerv Syst. 2012 Dec;28(12):2169-72. doi: 10.1007/s00381-012-1900-z. Epub 2012 Sep 1.

Abstract

INTRODUCTION

Split cord malformation (SCM) is rare congenital disorder of spine in which bony, fibrous, or cartilaginous septum subdivides partially or completely the vertebral canal. SCM can be associated with other spinal abnormalities such as spina bifida, Arnold-Chiari malformation, hemivertebra, butterfly vertebra, or kyphoscoliosis and also can be seen as part of Jarcho-Levin syndrome. Prenatal diagnosis of SCM is possible by ultrasonography (US). Fetal magnetic resonance imaging (MRI) and amniotic fluid acetylcholine esterase (AF-AChE) levels can be helpful to rule out additional anomalies. We present a case of fetal SCM diagnosed by US and fetal MRI.

CASE

An 18-year-old woman with no obstetrics risk factor was referred for routine US screening. At sagittal section, fetal spine was seen to be disordered. A coronal view of the spinal canal showed evidence of widening at the lower thoracic and lumbar level. An echogenic mass was identified within the enlarged spinal canal at level of T6-L5. Fetal MRI and AF-AChE analysis confirmed diagnosis and ruled out other anomalies and spina bifida. Neurological examination of the baby at 16 months of age was normal.

摘要

引言

脊髓纵裂畸形(SCM)是一种罕见的脊柱先天性疾病,其中骨、纤维或软骨隔膜部分或完全分隔椎管。SCM可与其他脊柱异常相关,如脊柱裂、阿诺德-奇阿利畸形、半椎体、蝴蝶椎或脊柱侧凸,也可视为贾科-莱文综合征的一部分。通过超声检查(US)可在产前诊断SCM。胎儿磁共振成像(MRI)和羊水乙酰胆碱酯酶(AF-AChE)水平有助于排除其他异常。我们报告一例经超声和胎儿MRI诊断的胎儿SCM病例。

病例

一名无产科危险因素的18岁女性因常规超声筛查前来就诊。在矢状面上,可见胎儿脊柱紊乱。椎管的冠状视图显示下胸段和腰段有增宽迹象。在T6-L5水平的扩大椎管内发现一个高回声团块。胎儿MRI和AF-AChE分析确诊并排除了其他异常和脊柱裂。婴儿16个月时的神经学检查正常。

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