开放性脊柱裂胎儿胼胝体异常的发生率及模式
Incidence and patterns of abnormal corpus callosum in fetuses with isolated spina bifida aperta.
作者信息
Kunpalin Yada, Deprest Jan, Papastefanou Ioannis, Bredaki Emma, Sacco Adalina, Russo Francesca, Richter Jute, Jansen Katrien, Ourselin Sebastien, De Coppi Paolo, David Anna L, Ushakov Fred, De Catte Luc
机构信息
Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.
Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium.
出版信息
Prenat Diagn. 2021 Jul;41(8):957-964. doi: 10.1002/pd.5945. Epub 2021 Apr 8.
OBJECTIVE
To determine the incidence and characterise corpus callosum (CC) abnormalities in fetuses with spina bifida aperta (SBA) between 18 and 26 weeks of gestation.
METHODS
This was a retrospective study on fetuses with isolated SBA and who were assessed for fetal surgery. Digitally stored ultrasound images of the brain were reviewed for the presence/absence of the CC, and the length and diameter of its constituent parts (rostrum, genu, body and splenium). We used regression analysis to determine the relationship between CC abnormalities and gestational age, head circumference, ventricle size, lesion level and lesion type.
RESULTS
Nearly three-quarters of fetuses with isolated SBA had an abnormal CC (71.7%, 76/106). Partial agenesis was most common in the splenium (18.9%, 20/106) and the rostrum (13.2%, 14/106). The most common abnormal pattern was of a short CC with normal diameter throughout. Of note, 20.8% (22/106) had a hypoplastic genu and 28.3% (30/106) had a thick body part. Larger lateral ventricle size was associated with partial agenesis of the CC (odds ratio [OR]: 0.14, p < 0.001) and inversely associated with a shorter CC (OR: 2.60, p < 0.01).
CONCLUSION
An abnormal CC is common in fetuses with isolated SBA who are referred for fetal surgery.
目的
确定妊娠18至26周开放性脊柱裂（SBA）胎儿胼胝体（CC）异常的发生率并对其特征进行描述。
方法
这是一项针对孤立性SBA胎儿且接受胎儿手术评估的回顾性研究。回顾数字化存储的脑部超声图像，以确定CC的有无及其组成部分（嘴部、膝部、体部和压部）的长度和直径。我们使用回归分析来确定CC异常与胎龄、头围、脑室大小、病变水平和病变类型之间的关系。
结果
近四分之三的孤立性SBA胎儿存在CC异常（71.7%，76/106）。部分发育不全在压部（18.9%，20/106）和嘴部（13.2%，14/106）最为常见。最常见的异常模式是整个CC直径正常但长度较短。值得注意的是，20.8%（22/106）的胎儿膝部发育不全，28.3%（30/106）的胎儿体部增厚。较大的侧脑室大小与CC部分发育不全相关（比值比[OR]：0.14，p<0.001），与较短的CC呈负相关（OR：2.60，p<0.01）。
结论
在因胎儿手术而转诊的孤立性SBA胎儿中，CC异常很常见。
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