Ramkrishna Jayshree, Araujo Júnior Edward, Peixoto Alberto Borges, Da Silva Costa Fabricio, Meagher Simon
Monash Ultrasound for Women, Melbourne, Australia.
Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.
J Matern Fetal Neonatal Med. 2019 Dec;32(24):4073-4079. doi: 10.1080/14767058.2018.1481384. Epub 2018 Jun 13.
To describe a new first-trimester sonographic landmark the maxillo-occipital line which may be useful for early screening of open spina bifida. Maxillo-occipital line was prospectively evaluated in 100 low-risk pregnancies at the time of first-trimester sonographic screening examination between 11 and 13 + 6 weeks' gestation. All the pregnant women subsequently had a normal second-trimester scan and normal outcomes. Midsagittal brain images of 14 fetuses with known diagnosis of open spina bifida were evaluated retrospectively to review the maxillo-occipital line. None of the 100 fetuses evaluated prospectively with the maxillo-occipital line below the junction of the midbrain and brain stem were affected by open spina bifida. The aqueduct of Silvius to occiput distance measurement was not obtained in five cases. In all, 14 cases with a diagnosis of open spina bifida, the junction between the midbrain and brain stem, were below the maxilla-occipital line. Maxillo-occipital line is an easy addition to the evaluation of first-trimester screening of open spina bifida. Further studies are needed to determine the false-positive and false-negative rates of this technique.
描述一种新的孕早期超声标志——枕颌线，其可能有助于开放性脊柱裂的早期筛查。在妊娠11至13⁺⁶周进行孕早期超声筛查时，对100例低风险妊娠的枕颌线进行前瞻性评估。所有孕妇随后均进行了正常的孕中期扫描且结局正常。对14例已知诊断为开放性脊柱裂胎儿的正中矢状脑图像进行回顾性评估以观察枕颌线。前瞻性评估中枕颌线位于中脑与脑干交界处下方的100例胎儿均未受开放性脊柱裂影响。5例未获得西尔维于斯导水管至枕骨距离测量值。在所有14例诊断为开放性脊柱裂的病例中，中脑与脑干交界处均低于枕颌线。枕颌线是孕早期开放性脊柱裂筛查评估中易于添加的一项内容。需要进一步研究以确定该技术的假阳性和假阴性率。
