正常胎儿和染色体异常胎儿的透明隔腔。

The cavum septi pellucidi in euploid and aneuploid fetuses.

机构信息

Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany.

出版信息

Ultrasound Obstet Gynecol. 2013 Aug;42(2):156-60. doi: 10.1002/uog.12393.

DOI:10.1002/uog.12393

PMID:23303556

Abstract

OBJECTIVE

To examine whether the cavum septi pellucidi (CSP) is larger in second- and third-trimester fetuses with chromosomal abnormalities than in euploid fetuses.

METHODS

This was a retrospective study utilizing stored two-dimensional images of second- and third-trimester fetuses between 18 and 40 weeks' gestation from three centers in Germany. The width of the CSP was measured by placing the calipers on the inner portion of its lateral borders. Two operators, both of whom were blinded to the fetal karyotype and to the measurements obtained by the other, measured the CSP width. The normal range in euploid fetuses was computed based on the biparietal diameter (BPD) by applying univariate regression analysis. The CSP width in euploid and aneuploid fetuses was transformed into Z-scores and compared using Student's t-test. Univariate regression analysis was used to determine the dependency of Z-score on head biometry.

RESULTS

The study population consisted of 406 singleton pregnancies, 267 with euploid fetuses, 81 with trisomy 21, 50 with trisomy 18 and eight with trisomy 13. In the euploid group, the mean CSP width was 4.5 (range, 1.8-7.4) mm. Regression analysis showed a significant dependency of CSP width on BPD (CSP width = 0.658 + (0.064 × BPD), r = 0.781, P < 0.0001; both parameters in mm). The mean CSP width increased from 3.2 to 7.1 mm for BPD values of 40 to 100 mm, respectively. In the groups of fetuses with trisomy 21, 18 and 13, mean CSP width was 5.7 (range, 2.8-10.5), 7.9 (range, 3.5-12.8) and 5.8 (range, 4.0-9.0) mm, respectively. In 42.0% of the fetuses with trisomy 21, CSP width was above the 95(th) centile. In trisomy 18 and 13, CSP width was above the 95(th) centile in 92.0% and 37.5% of cases, respectively.

CONCLUSION

A large CSP width should prompt a detailed ultrasound examination to further assess the risk for chromosomal abnormalities.

摘要

目的

研究在 2 至 3 孕期有染色体异常的胎儿中，透明隔腔（CSP）是否大于正常胎儿。

方法

这是一项回顾性研究，利用了德国三个中心在 18 至 40 孕周之间的二维图像。通过将卡尺放在其侧边界的内部部分来测量 CSP 的宽度。两名操作员都对胎儿的核型和其他操作员获得的测量值均不知情，他们分别测量了 CSP 的宽度。基于头围（BPD），通过单变量回归分析计算出正常胎儿的 CSP 正常范围。将正常和非整倍体胎儿的 CSP 宽度转换为 Z 分数，并使用学生 t 检验进行比较。使用单变量回归分析来确定 Z 分数对头生物测量的依赖性。

结果

研究人群包括 406 例单胎妊娠，其中 267 例为正常核型胎儿，81 例为 21 三体，50 例为 18 三体，8 例为 13 三体。在正常核型组中，CSP 的平均宽度为 4.5（范围，1.8-7.4）mm。回归分析显示 CSP 宽度与 BPD 显著相关（CSP 宽度=0.658+（0.064×BPD），r=0.781，P<0.0001；两个参数均以 mm 为单位）。BPD 值为 40 至 100mm 时，CSP 宽度分别从 3.2 增加到 7.1mm。21、18 和 13 三体组的 CSP 平均宽度分别为 5.7（范围，2.8-10.5）、7.9（范围，3.5-12.8）和 5.8（范围，4.0-9.0）mm。21 三体组中有 42.0%的胎儿 CSP 宽度超过第 95 百分位数。18 三体和 13 三体组中，92.0%和 37.5%的胎儿 CSP 宽度超过第 95 百分位数。