视交叉的尺寸：无眼/小眼胎儿与正常胎儿之间的定量超声比较

Dimensions of the optic chiasm: quantitative ultrasound comparison between fetuses with anophthalmia/microphthalmia and normal fetuses.

作者信息

Wu Li-Hong, Zheng Qiao, He Miao, Zhang Li-He, Du Liu, Xie Hong-Ning

机构信息

Department of Ultrasonic Medicine, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Quant Imaging Med Surg. 2021 Oct;11(10):4389-4398. doi: 10.21037/qims-21-151.

DOI:10.21037/qims-21-151

PMID:34603993

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8408779/

Abstract

BACKGROUND

The precise pathogenesis of anophthalmia/microphthalmia remains unknown. Prenatal observation of the optic chiasm in fetuses with this malformation would assist in understanding the embryonic development of the condition. The present study aimed to establish the normal fetal size ranges of decussation of the optic chiasm, optic nerves, and optic tracts in the axial plane using two-dimensional transabdominal ultrasound throughout gestation and to compare these ranges to the corresponding values in fetuses with anophthalmia/microphthalmia.

METHODS

In total, 310 normal fetuses and 16 fetuses with anophthalmia/microphthalmia were included in this study. The widths of the decussation of the optic chiasm, optic nerves, and optic tracts of normal fetuses at 19-40 weeks' gestation were measured in the axial plane by two-dimensional transabdominal ultrasound. The same widths were retrospectively measured in the axial plane using three-dimensional ultrasound in fetuses with anophthalmia/microphthalmia and compared to the results from the normal fetuses.

RESULTS

The decussation, optic nerves, and optic tracts of 310 normal fetuses were measured. The normal widths of the decussation of the optic chiasm, optic nerves, and optic tracts increased linearly with gestational age. The interobserver and intraobserver reproducibility was excellent for the decussation but relatively low for the optic nerves and optic tracts. The optic nerve width of fetuses with anophthalmia/microphthalmia was significantly smaller than that of normal fetuses (P<0.001), but the widths of the decussation (P=0.061) and optic tracts (P=0.053) were not significantly different between the two groups.

CONCLUSIONS

The normal ranges of the decussation of the optic chiasm, optic nerves, and optic tracts established in this study can provide a quantitative basis for prenatal evaluation of the optic pathway. Fetal anophthalmia/microphthalmia may be associated with optic nerve hypoplasia.

摘要

背景

无眼/小眼畸形的确切发病机制尚不清楚。对患有这种畸形的胎儿进行视交叉的产前观察将有助于了解该病症的胚胎发育情况。本研究旨在通过二维经腹超声确定整个孕期轴平面内视交叉、视神经和视束交叉的正常胎儿大小范围，并将这些范围与无眼/小眼畸形胎儿的相应值进行比较。

方法

本研究共纳入310例正常胎儿和16例无眼/小眼畸形胎儿。在妊娠19至40周时，通过二维经腹超声在轴平面测量正常胎儿视交叉、视神经和视束交叉的宽度。使用三维超声在轴平面回顾性测量无眼/小眼畸形胎儿的相同宽度，并与正常胎儿的结果进行比较。

结果

测量了310例正常胎儿的视交叉、视神经和视束。视交叉、视神经和视束交叉的正常宽度随孕周呈线性增加。观察者间和观察者内对视交叉交叉的重复性极佳，但对视神经和视束的重复性相对较低。无眼/小眼畸形胎儿的视神经宽度明显小于正常胎儿（P<0.001），但两组间视交叉交叉宽度（P=0.061）和视束宽度（P=0.053）无显著差异。