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距状沟的形成:预测孤立性轻度胎儿脑室扩大宫内进展的潜在标志物。

Formation of the calcarine sulcus: a potential marker to predict the progression in utero of isolated mild fetal ventriculomegaly.

作者信息

Li Hehong, Liu Guangjian, Lin Fangqin, Liang Huiying

机构信息

Department of Radiology Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

出版信息

Medicine (Baltimore). 2017 Jul;96(28):e7506. doi: 10.1097/MD.0000000000007506.

Abstract

Our previous study confirmed the negative association between the development of calcarine sulcus and the width of lateral ventricles. The purpose of current study was to evaluate the reliability of calcarine sulcus depth in the 2nd trimester to predict the prenatal enlargement of lateral ventricle in fetuses with isolated mild fetal ventriculomegaly (IMVM).This study used a retrospective cohort study design. A total of 97 pregnant women with IMVM diagnosed between 20 and 26 weeks' gestation returned for a 2nd examination at 30 to 32 weeks. Lateral ventricular size and calcarine sulcus depth were acquired from ultrasonography and magnetic resonance imaging (MRI) scans, respectively. Progression was defined as the process of developing from a lower group toward a higher (<10 mm, 10-12 mm, 13-15 mm, and ≥16 mm).Significant correlation was observed between calcarine sulcus depth and ventricular measurements at the 2nd scan (r = -0.71, P < .0001). Receiver-operating characteristic curves showed that calcarine sulcus depth (area under curve [AUC] = 0.83, 95% confidence interval [CI] = 0.74-0.92) had the best diagnostic performance in predicting the prenatal progression, as compared with lateral ventricle width (AUC = 0.69, 95%CI = 0.54-0.84) and gestational age (AUC = 0.70, 95%CI = 0.57-0.83) at the initial scan. The cutoff value for calcarine sulcus depth was 3.3 mm, with the corresponding sensitivity and specificity were 75.0% and 81.3%, respectively. Multivariate analyses showed that calcarine sulcus depth ≥3.3 mm (odds ratio = 0.09, 95%CI = 0.02-0.38, P = .001) was an independent predictor of the prenatal progression.For IMVM, calcarine sulcus depth might be a powerful marker to identify subjects at higher risk for worse prenatal progression.

摘要

我们之前的研究证实了距状沟发育与侧脑室宽度之间存在负相关。本研究的目的是评估孕中期距状沟深度预测孤立性轻度胎儿脑室扩大(IMVM)胎儿产前侧脑室扩大的可靠性。本研究采用回顾性队列研究设计。共有97例在妊娠20至26周被诊断为IMVM的孕妇在30至32周时返回进行第二次检查。分别通过超声检查和磁共振成像(MRI)扫描获取侧脑室大小和距状沟深度。进展被定义为从较低组向较高组(<10mm、10 - 12mm、13 - 15mm和≥16mm)发展的过程。在第二次扫描时,观察到距状沟深度与脑室测量值之间存在显著相关性(r = -0.71,P <.0001)。受试者工作特征曲线显示,与初始扫描时的侧脑室宽度(曲线下面积[AUC] = 0.69,95%置信区间[CI] = 0.54 - 0.84)和孕周(AUC = 0.70,95%CI = 0.57 - 0.83)相比,距状沟深度(AUC = 0.83,95%CI = 0.74 - 0.92)在预测产前进展方面具有最佳诊断性能。距状沟深度截断值为3.3mm,相应的敏感性和特异性分别为75.0%和81.3%。多因素分析显示,距状沟深度≥3.3mm(比值比 = 0.09,95%CI = 0.02 - 0.38,P =.001)是产前进展的独立预测因素。对于IMVM,距状沟深度可能是识别产前进展较差风险较高受试者的有力标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6854/5515772/13e1d495ab71/medi-96-e7506-g001.jpg

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