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一种通过二维轴向平面评估胎儿胼胝体的新方法。

A novel technique to assess fetal corpus callosum by two-dimensional axial plane.

机构信息

Department of Ultrasound, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, 518028, Guangdong, China.

出版信息

Eur Radiol. 2020 Nov;30(11):5871-5880. doi: 10.1007/s00330-020-06981-9. Epub 2020 Jun 16.

Abstract

OBJECTIVE

The definition of new normal values of the corpus callosum (CC) in axial sonographic scans and evaluation of their feasibility in diagnosing abnormal CC.

METHODS

A cross-sectional study assessed CC from 20-gestational-week to full-term. CC observations across three axial planes (the largest CC length plane, trans-genu-and-splenium plane, and trans-body plane) were developed. The largest CC length, genu and splenium thickness, and body width and thickness were compared with compound scatter plots. Ultrasonographic features of normal and abnormal CC were described and the feasibility of the new approach studied. Intra-class correlation coefficient (ICC) was used for assessing the intra- and inter-observer agreements.

RESULTS

Six hundred seventy normal and 42 abnormal fetuses from 20-gestational-week to full-term were studied. The mean normal and abnormal group maternal ages were 30.46 ± 4.36 years and 29.69 ± 4.49 years (p = 0.269). The success rate in obtaining satisfactory axial planes reached 100% but only 13.9% for sagittal plane in the normal group. The success rate of abnormal cases obtaining satisfactory axial planes was 100% and 59.5% by sagittal plane (p < 0.05). The compound scatter plots of abnormal and normal groups showed that the largest CC length and body width were significantly lower in normal fetuses, and the thickness of the genu and splenium with CC hypoplasia was significantly lower than normal fetuses. The intra- and inter-observer agreements were reproducible (all ICC > 0.850).

CONCLUSIONS

The feasibility of incorporating an evaluation of CC into routine anatomical screening was demonstrated. Additionally, a focused examination of the craniocerebral axial planes exploring CC at the time of central nervous system scanning might facilitate CC anomaly detection.

KEY POINTS

• Three axial planes with direct CC measurements can detect CC anomalies more accurately compared with indirect CC signs. Besides, this method is simpler, more convenient, and time-saving compared with the sagittal plane. • Assessing fetal CC on the axial plane helps clinicians to diagnose fetuses with abnormal CC. • A prospective single-center study showed that our new technique provides enough diagnostic confidence.

摘要

目的

确定轴位超声扫描中胼胝体(CC)的新正常值,并评估其在诊断异常 CC 中的可行性。

方法

采用横断面研究评估了 20 孕周至足月胎儿的 CC。在三个轴位平面(最大 CC 长度平面、经膝和压部平面以及经体部平面)观察 CC。比较了最大 CC 长度、膝部和压部厚度以及体部宽度和厚度的复合散点图。描述了正常和异常 CC 的超声特征,并研究了新方法的可行性。使用组内相关系数(ICC)评估观察者内和观察者间的一致性。

结果

研究了 20 孕周至足月的 670 例正常和 42 例异常胎儿。正常组和异常组的平均母体年龄分别为 30.46±4.36 岁和 29.69±4.49 岁(p=0.269)。正常组获得满意轴位平面的成功率达到 100%,但矢状位平面仅为 13.9%。异常组获得满意轴位平面的成功率为 100%,矢状位平面为 59.5%(p<0.05)。异常组和正常组的复合散点图显示,正常胎儿的最大 CC 长度和体宽明显较低,CC 发育不良的膝部和压部厚度明显低于正常胎儿。观察者内和观察者间的一致性具有可重复性(所有 ICC>0.850)。

结论

将 CC 评估纳入常规解剖筛查具有可行性。此外,在中枢神经系统扫描时,对颅脑部轴位平面进行针对性检查,可能有助于发现 CC 异常。

关键点

  1. 与间接 CC 征象相比,直接测量 CC 的三个轴位平面可以更准确地检测 CC 异常。此外,与矢状位平面相比,该方法更简单、更方便、更省时。

  2. 在轴位平面评估胎儿 CC 有助于临床医生诊断 CC 异常的胎儿。

  3. 一项前瞻性单中心研究表明,我们的新技术提供了足够的诊断信心。

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