de Sá Barreto Enoch Quinderé, Moron Antonio Fernandes, Milani Hérbene José Figuinha, Hisaba Wagner Jou, Nardozza Luciano Marcondes Machado, Araujo Júnior Edward, Cavalheiro Sérgio
Fetal Neurology Division, Department of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), Rua Carlos Weber, 956, apto. 113 Visage, São Paulo, SP, Brazil.
Childs Nerv Syst. 2015 May;31(5):729-33. doi: 10.1007/s00381-015-2621-x. Epub 2015 Feb 21.
The aims of this study were to describe a new ultrasonographic technique to assess the normal level of the cerebellum and the brainstem in the posterior fossa in normal foetuses and to compare in pathologic cases.
We propose a new line cross between the dens cervical and the inferior portion of occipitum (occipitum-dens line-ODL). In a cross-sectional study, a single observer with experience in foetal neurosonography evaluated 54 foetuses (40 normal and 14 with open neural tube defect) between 20 and 28 weeks of gestation. The reference points for the ODL are principally the lower portion of the occipital bone (occipitum) and odontoid process of the second cervical vertebra (dens). The line was considered the level zero (near level of foramen magnum). Structures above it had a positive measurement and below it had a negative measurement.
Moreover, in most foetuses with open neural tube defect (93 %), the end portion of cerebellum was below the ODL associated with different degrees of ventriculomegaly.
The proposed innovation aims to bring to the ultrasound the most likely anatomical parameters of evaluation in normal foetuses and in foetuses with spinal dysraphism.
本研究的目的是描述一种新的超声技术，用于评估正常胎儿后颅窝中小脑和脑干的正常水平，并在病理情况下进行比较。
我们提出了一种在颈椎齿状突和枕骨下部（枕骨-齿状突线-ODL）之间的新的线交叉方法。在一项横断面研究中，一名有胎儿神经超声经验的观察者评估了54例妊娠20至28周的胎儿（40例正常胎儿和14例开放性神经管缺陷胎儿）。ODL的参考点主要是枕骨下部（枕骨）和第二颈椎齿状突（齿状突）。该线被视为零水平（接近枕骨大孔水平）。其上方的结构测量值为正，下方的结构测量值为负。
此外，在大多数开放性神经管缺陷胎儿（93%）中，小脑末端低于ODL，并伴有不同程度的脑室扩大。
所提出的创新旨在为超声检查提供正常胎儿和脊柱裂胎儿最有可能的解剖学评估参数。
