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[胼胝体发育不全的产前诊断及其与胎儿染色体异常的关系]

[Prenatal diagnosis of agenesis of corpus callosum and its relationship with fetal chromosomal abnormalities].

作者信息

Chang Qing-xian, Zhong Mei, Yu Yan-hong, Xiong Li, Chen Cui-hua, Chen Geng, Li Sheng-li, Song Lan-Lin

机构信息

Department of Gynecology and Obstetrics,Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

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出版信息

Zhonghua Fu Chan Ke Za Zhi. 2013 Nov;48(11):810-4.

Abstract

OBJECTIVES

To evaluate prenatal imaging diagnosis of agenesis of corpus callosum and to investigate the relationship between ACC and chromosomal abnormalities.

METHODS

Forty singleton pregnancies diagnosed ACC prenatally in Southern Medical University,Nanfang Hospital,General Hospital of Guangzhou Military Command of PLA and Shenzhen Maternity and Children Health Care Hospital from 2007 to 2012 were recruited. The correlation between ACC and chromosomal abnormalities, the consistence of sonographic characteristics and MRI diagnosis were analyzed retrospectively.

RESULTS

(1) Among the 40 cases, 15 (38%, 15/40) were diagnosed isolated ACC, while 25 (63%, 25/40) were non-isolated ACC.In the non-isolated ACC cases, 18 (72%) had central nervous system abnormalities, including cerebellar vermis hypoplasia,Dandy-Walker syndrome, cerebellar cyst, holoprosencephaly, etc.Extra-CNS abnormalities were identified in 16 cases, including 5 cardiac abnormalities, 3 facial abnormalities, 2 congenital anomalies of urinary system, 1 limb skeletal abnormality and 5 other congenital anomalies.(2) In the 40 cases, 3 were chromosomal polymorphisms, including 2 cases of 46,XX, 1qh+ and 1 case of 46,XY, 13cenh+. Chromosomal abnormalities were identified in 4 cases, including trisomy13, trisomy18, trisomy 21 and 47,XYY.(3) 36 cases(90%, 36/40) diagnosed by ultrasound were consistent with MRI, while 4 cases were different with MRI.37 pregnancies were terminated, in which 28 cases were confirmed by fetal autopsy.3 cases continued pregnancy and ACC was confirmed by postnatal MRI.(4) 25 non-isolated ACC and 12 isolated ACC pregnancies were terminated. Among the 3 isolated ACC cases that continued pregnancy, 2 were term delivery and 1 was premature delivery. All of them were confirmed by postnatal MRI.No mental or growth retardation was found during follow-up.

CONCLUSION

MRI was prior to detect cases with non-isolated ACC and could be a supplementary method in the diagnosis and classification of ACC. Compared with isolated ACC, non-isolated ACC had a higher incidence of chromosomal abnormalities.

摘要

目的

评估胼胝体发育不全的产前影像诊断,并探讨胼胝体发育不全(ACC)与染色体异常之间的关系。

方法

选取2007年至2012年在南方医科大学南方医院、广州军区广州总医院及深圳市妇幼保健院产前诊断为ACC的40例单胎妊娠病例。回顾性分析ACC与染色体异常之间的相关性,以及超声特征与MRI诊断的一致性。

结果

(1)40例病例中,15例(38%,15/40)诊断为孤立性ACC,25例(63%,25/40)为非孤立性ACC。在非孤立性ACC病例中,18例(72%)有中枢神经系统异常,包括小脑蚓部发育不全、Dandy-Walker综合征、小脑囊肿、全前脑畸形等。16例有中枢神经系统外异常,包括5例心脏异常、3例面部异常、2例泌尿系统先天性畸形、1例肢体骨骼异常和5例其他先天性畸形。(2)40例病例中,3例为染色体多态性,包括2例46,XX,1qh+和1例46,XY,13cenh+。4例有染色体异常,包括13三体、18三体、21三体和47,XYY。(3)超声诊断的36例(90%,36/40)与MRI结果一致,4例与MRI结果不同。37例妊娠终止,其中28例经胎儿尸检证实。3例继续妊娠,产后MRI证实为ACC。(4)25例非孤立性ACC和12例孤立性ACC妊娠终止。继续妊娠的3例孤立性ACC病例中,2例足月分娩,1例早产。均经产后MRI证实。随访期间未发现智力或生长发育迟缓。

结论

MRI在检测非孤立性ACC病例方面更具优势,可作为ACC诊断和分类的辅助方法。与孤立性ACC相比,非孤立性ACC染色体异常的发生率更高。

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