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产前 MRI 对孤立性脑室扩张的诊断及对早期产后发育结局的预测价值。

Clinical value of prenatal MRI for diagnosis of isolated ventriculomegaly and prediction of early postnatal developmental outcomes.

机构信息

Department of Radiology, Maternity and Child Care Hospital, Huzhou, China.

Department of Endocrinology, Huzhou Central Hospital, Huzhou, China.

出版信息

Prenat Diagn. 2019 Jan;39(2):124-129. doi: 10.1002/pd.5399. Epub 2019 Jan 13.

Abstract

OBJECTIVE

To investigate the relationship of ventriculomegaly (VM) with postnatal neurological development.

METHODS

Fetuses with isolated VM on MRI (n = 160; VM group) were separated into three subgroups according to lateral ventricle width: subgroup A (10.0-12.0 mm; n = 113), subgroup B (12.1-15.0 mm; n = 37), and subgroup C (>15.0 mm; n = 10). Fifty normal fetuses formed a control group. Post-delivery changes in ventricular width and neurological development were assessed with MRI/ultrasonography and the Gesell Development Schedules (GDS), respectively, at 3, 6, 12, and 18 months.

RESULTS

GDS scores of subgroup A and subgroup B did not differ from that of the controls at 3 and 6 months. Subgroup B scores differed significantly from the control scores at 12 and 18 months. Subgroup C scores differed from the control scores at all-time points (all P < 0.05). In the VM group, GDS scores at 12 and 18 months were significantly different from the scores at 3 months, and the score at 18 months was significantly different from the score at 6 months (P < 0.05 for all).

CONCLUSION

The milder the VM, the more likely it was to disappear or improve in the postnatal period. However, specific postnatal rehabilitation should be considered when fetal ventricular width is greater than 12.1 mm.

摘要

目的

研究脑室扩大(VM)与产后神经发育的关系。

方法

将 MRI 检查发现孤立性 VM 的胎儿分为三组:A 亚组(10.0-12.0mm;n=113)、B 亚组(12.1-15.0mm;n=37)和 C 亚组(>15.0mm;n=10)。B 亚组和 C 亚组新生儿出生后,均采用 MRI/超声测量脑室宽度,随访至 3、6、12 和 18 个月。采用盖塞尔发育量表(GDS)评估神经发育情况。

结果

3、6 个月时,A 亚组和 B 亚组 GDS 评分与对照组无差异;12、18 个月时,B 亚组 GDS 评分与对照组有差异。各亚组均与对照组在各个时间点比较,差异均有统计学意义(均 P<0.05)。VM 组 12、18 个月 GDS 评分与 3 个月时比较,差异均有统计学意义(均 P<0.05);18 个月时 GDS 评分与 6 个月时比较,差异有统计学意义(P<0.05)。

结论

VM 越轻,在产后越有可能消失或改善。但当胎儿脑室宽度大于 12.1mm 时,应考虑特定的产后康复治疗。

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