早孕期帆状胎盘间隔腔：发生率及自然史。

Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL, USA.

Department of Radiology, University of Florida, Gainesville, FL, USA.

Ultrasound Obstet Gynecol. 2024 Apr;63(4):502-506. doi: 10.1002/uog.27523.

OBJECTIVE

To confirm the identity and assess the prevalence and evolution of the fluid-filled interhemispheric midline structure, thought to be the cavum veli interpositi (CVI), in fetuses at 11-14 weeks' gestation.

METHODS

This was a retrospective study of first-trimester ultrasound scans performed at a single center over 3 months. Inclusion criteria were singleton pregnancies at 11-14 weeks' gestation with known neonatal outcome. Five experts reviewed the images. Mixed-effects logistic regression and generalized estimating equations (GEE) were conducted to analyze the associations between the presence of the structure and variables including ultrasound approach (transabdominal vs transvaginal), maternal body mass index (BMI), gestational age, fetal crown-rump length (CRL) and biparietal diameter (BPD). Second-trimester ultrasound scans of the fetal central nervous system at 18-24 weeks' gestation were evaluated for the persistence of the CVI in fetuses in which the structure was observed in the first trimester.

RESULTS

Of the 223 cases reviewed, 104 were included, among which the CVI was observed in 25 (24%) cases. There was no statistically significant difference in CVI visualization between transabdominal and transvaginal ultrasound examinations. GEE showed significant associations between the presence of the fetal structure and CRL (odds ratio (OR) per 10-unit increase, 1.32; P < 0.0001) and BPD (OR per 10-unit increase, 1.88; P = 0.0011). Maternal BMI and gestational age showed no significant effect on the presence of the CVI. At second-trimester follow-up of the 25 fetuses in which the CVI was observed initially, 44% still showed a CVI, 32% exhibited a cavum vergae, 4% had both structures and 20% had neither.

CONCLUSIONS

Based on its anatomical location and, in some fetuses, its visualization as a distinct entity from the third ventricle, the identity of the interhemispheric midline structure in the suprathalamic region of the fetal brain between 11-14 weeks' gestation was confirmed as the CVI. The CVI and/or cavum vergae persisted into the second trimester in 80% of fetuses identified initially as having a CVI. Its presence is not linked to pathology, offering reassurance to practitioners and parents. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

目的

确认在 11-14 孕周胎儿中，被认为是中间帆腔（CVI）的充满液体的大脑半球间正中结构的存在，并评估其发生率和演变。

方法

这是一项在单中心进行的为期 3 个月的回顾性研究，纳入标准为 11-14 孕周的单胎妊娠且新生儿结局已知。5 名专家对图像进行了回顾。采用混合效应逻辑回归和广义估计方程（GEE）分析该结构的存在与超声方法（经腹与经阴道）、母体体重指数（BMI）、孕龄、胎儿头臀长（CRL）和双顶间径（BPD）等变量之间的相关性。对 18-24 孕周胎儿的中枢神经系统进行二次超声检查，以评估在首次孕期观察到该结构的胎儿中，该结构是否持续存在。

结果

在 223 例中，有 104 例符合纳入标准，其中 25 例（24%）观察到 CVI。经腹和经阴道超声检查之间，CVI 的可视化无统计学差异。GEE 显示，该胎儿结构的存在与 CRL（每增加 10 个单位的比值比，1.32；P<0.0001）和 BPD（每增加 10 个单位的比值比，1.88；P=0.0011）显著相关。母体 BMI 和孕龄对 CVI 的存在无显著影响。在最初观察到 CVI 的 25 例胎儿中，有 44%在二次孕期仍存在 CVI，32%显示有脉络丛裂，4%两者均有，20%两者均无。