Ultrasound measurement of fetal posterior fossa at 11 to 13 + 6 gestational weeks for screening open spina bifida
10.3969/j.issn.1673-4254.2014.07.07
- VernacularTitle:11~13+6周胎儿颅后窝结构的产前超声检测
- Author:
Fengzhen QIN
1
;
Shengli LI
;
Huaxuan WEN
;
Yurong OUYANG
;
Qiong ZHENG
;
Jingru BI
Author Information
1. 南方医科大学附属深圳市妇幼保健院超声科
- Keywords:
fetus;
first trimester;
11~13+6 weeks;
posterior fossa;
open spina bifida
- From:
Journal of Southern Medical University
2014;(7):950-955
- CountryChina
- Language:Chinese
-
Abstract:
Objective To establish the normal reference ranges of transabdominal ultrasound measurements of the posterior fossa structure in fetuses at 11 to 13+6 gestational weeks and explore their clinical value in screening open spina bifida (OSB). Methods Between January, 2013 and September, 541 randomly selected normal fetuses underwent nuchal translucency at the gestational age 11 to 13+6 weeks. The parameters of the posterior fossa were measured in mid-sagittal view of the fetal face and the axial view of the transverse cerebellum insonated through the anterior fontanel by transabdominal ultrasound to establish the normal reference ranges. The measurements were obtained from 3 fetuses with OSB for comparison with the reference ranges. Results In normal fetuses, the parameters of the posterior fossa measured in the two views showed no significant differences (P>0.05). Two high echogenic lines were observed in normal fetuses, as compared with one in fetuses with OSB representing the posterior border of the brain stem and the anterior border of the fourth ventricle. The line between the posterior border of the fourth ventricle and the anterior border of the cisterna magna was not displayed in fetuses with OSB. The anteroposterior diameters of the brain stem, the fourth ventricle, and cisterna magna all increased in positive correlation with the crown-lump length in normal fetuses. In the 3 OSB fetuses, the anteroposterior diameter of the brain stem exceeded the 95th percentile and the anteroposterior diameter of fourth ventrical-cisterner magena was below the 5th percentile of the reference range for CRL;the brain stem to fourth ventrical-cisterner magena anteroposterior diameter ratio was increased to above 1. Conclusion The established normal reference ranges of the parameters of fetal posterior fossa may provide assistance in early OSB detection. The absence of the posterior border of the fourth ventricle and the anterior border of the cisterna magna and a brainstem to fourth ventrical-cisterner magena anteroposterior diameter ratio greater than 1 can be indicative of OSB at 11 to 13+6 gestational weeks.
