透明隔腔（CSP）比值：胎儿胼胝体部分发育不全的一个标志物。

Cavum septi pellucidi (CSP) ratio: a marker for partial agenesis of the fetal corpus callosum.

机构信息

Center for Prenatal Diagnosis Munich, Munich, Germany.

Department of Obstetrics and Gynecology, Ludwig-Maximilians-University, Munich, Germany.

出版信息

Ultrasound Obstet Gynecol. 2017 Sep;50(3):336-341. doi: 10.1002/uog.17409. Epub 2017 Aug 9.

DOI:10.1002/uog.17409

PMID:28078790

Abstract

OBJECTIVE

While complete agenesis of the corpus callosum is often suspected on fetal ultrasound due to absence of the cavum septi pellucidi (CSP), suspicion of partial agenesis of the corpus callosum (pACC) is a challenge since the CSP is almost always present. The aim of this study was to measure the length and width of the CSP and calculate the length-to-width ratio (CSP ratio), and compare these between fetuses with pACC and normal fetuses.

METHODS

In this retrospective case-control study, the length and width of the CSP were measured in the axial plane of the fetal head, and the CSP length-to-width ratio calculated, in 323 normal fetuses and in 20 fetuses with pACC between 20 and 34 weeks' gestation. From the normal population we constructed reference ranges in relation to biparietal diameter (BPD). For all fetuses we calculated Z-scores for the CSP ratio.

RESULTS

In the normal population, the length and width of the CSP increased with increasing BPD, while the CSP ratio decreased. The CSP was short (< 5 centile) in 85% (17/20) of fetuses with pACC and wide (> 95 centile) in 65% (13/20). The CSP ratio was small (< 5 centile) in 95% (19/20) of pACC fetuses, with 16/20 (80%) having a ratio below an empirical cut-off of 1.5. Analysis of Z-scores showed that fetuses with pACC had a significantly smaller CSP ratio (P < 0.0001) compared with the normal population.

CONCLUSIONS

Fetuses with a normal-sized corpus callosum have a rectangular-shaped CSP, with a CSP ratio > 1.5 in the second half of gestation. Most fetuses with pACC have an abnormally shaped, wide and short CSP, with a decreased CSP ratio. This simple ratio has the potential to identify fetuses at high risk for pACC. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

摘要

目的

由于缺少透明隔腔（CSP），在胎儿超声检查时常怀疑完全性胼胝体发育不全，但由于 CSP 几乎总是存在，因此对部分性胼胝体发育不全（pACC）的怀疑是一个挑战。本研究旨在测量 CSP 的长度和宽度，并计算长度与宽度的比值（CSP 比值），比较 pACC 胎儿与正常胎儿之间的差异。

方法

在这项回顾性病例对照研究中，我们在胎儿头部的轴位平面上测量了 323 例正常胎儿和 20 例 20-34 孕周 pACC 胎儿的 CSP 长度和宽度，并计算了 CSP 长度与宽度的比值。我们构建了与双顶径（BPD）相关的正常人群 CSP 比值参考范围。我们还为所有胎儿计算了 CSP 比值的 Z 分数。

结果

在正常人群中，CSP 的长度和宽度随 BPD 的增加而增加，而 CSP 比值则降低。20 例 pACC 胎儿中，有 17 例（85%）的 CSP 较短（<第 5 百分位数），有 13 例（65%）的 CSP 较宽（>第 95 百分位数）。20 例 pACC 胎儿中有 19 例（95%）的 CSP 比值较小（<第 5 百分位数），其中 16 例（80%）的比值低于经验性截断值 1.5。Z 分数分析显示，pACC 胎儿的 CSP 比值明显小于正常人群（P < 0.0001）。