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目的通过二维和三维超声检查,研究胎儿小脑蚓部及其相关结构,对比其诊断小脑蚓部病变的准确性。方法对64例在二维超声检查中发现可疑小脑蚓部异常、胎龄18～40周的胎儿进一步行三维超声重建检查小脑蚓部及其相关结构。结果二维超声仅可于冠状面上清楚显示小脑半球及上蚓部结构,矢状面获得小脑切面不理想;三维超声则可进一步于矢状面清晰显示小脑原裂及下后裂、第四脑室与后颅窝池等相通结构,并可用三维容积断层技术(TUI)逐层显示系列连续的胎儿脑矢状切面。结论三维超声可较清晰显示胎儿小脑蚓部在18孕周以后的发育表现及较明确筛查出小脑蚓部畸形,是诊断小脑畸形的较为理想的影像学方法,可增进胎儿颅脑检查的完整性,提高产前诊断的符合率,减少漏诊。
Objective To study the vermis and its related structures of fetal cerebellum by two-dimensional and three-dimensional ultrasonography and compare the accuracy of diagnosing cerebellar vermis. Methods Fetal cerebellar vermis and its related structures were further examined by three-dimensional ultrasonography in 64 cases with suspected abnormalities of cerebellar vermis in two-dimensional ultrasonography and fetuses aged 18-40 weeks. Results Two-dimensional ultrasonography showed the cerebellar hemispheres and the vermis only clearly on the coronal plane. The sagittal plane was not ideal for the cerebellar slices. Three-dimensional ultrasonography could further show the cerebellar rupture and the posterior cleft in the sagittal plane. Ventricular and posterior fossa pools and other structures connected, and three-dimensional volumetric tomography (TUI) can be used to display a series of successive fetal brain sagittal section. Conclusion Three-dimensional ultrasonography can clearly show the development of fetal cerebellar vermis after 18 weeks of gestation and more clearly detect cerebellar vermis deformity. It is an ideal imaging method for diagnosis of cerebellar deformity, which can improve the integrity of fetal brain examination Sex, improve the coincidence rate of prenatal diagnosis, reduce missed diagnosis.