胎儿孤立性小脑延髓池增宽的超声诊断及预后

摘要

Objective To evaluate the clinical characteristics and the corresponding outcome of fetuses with isolated maga cisterna magna(MCM)diagnosed by prenatal ultrasonography. Methods Clinical data of 32 fetuses with isolated MCM diagnosed by prenatal ultrasonography were analyzed retrospectively. Postnatal follow-up was also conducted, the nature history of MCM and children, nervous system development were emphatically observed. Results Totally 32 fetuses were successfully followed up, the average width of the cisterna magna was 13.2 mm (10.4～ 17.2 mm). The pregnancy was terminated in 7 pregnant women(chromosomal aberration trisomy 18 in 1 fetus). 25 fetuses were delivered (15 males and 10 females), 2 of them died during the early neonatal period. Among the 23 infants that remained in follow-up, 22 were normal, while 1 case got nervous system developmental retardation (language deficit and delayed walking). Spontaneous regression of the MCM during the late pregnancy and early neonatal period occurred in 10 cases. Conclusions Ultrasonography is an effective method for prenatal diagnosis and dynamic observation of MCM. These lesions. when isolated, may be associated with a favorable outcome, however, postnatal follow up is strongly recommended.%目的 探讨超声诊断的胎儿孤立性小脑延髓池增宽的临床特点及预后情况.方法 回顾性分析我院产前诊断的32例孤立性小脑延髓池增宽(maga cisterna magna,MCM)的资料,并进行产后追踪随访,重点观察MCM的转归及患儿神经系统发育情况.结果 产前超声诊断并成功随访胎儿孤立性MCM 32例,小脑延髓池宽度10.4～1 7.2 cm,平均宽度13.2 mm.7例孕妇选择引产(其中一胎证实为18-三体),其余25胎活产(男胎15例,女胎10例).活产病例中,2例于生后30 d内死亡,23例存活,其中1例发生神经系统发育迟滞(语言及行走障碍),余22例未见异常.10例于妊娠晚期及新生儿期超声复查MCM自然消退.结论 超声检查是胎儿MCM产前诊断及随访观察的有效方法,孤立性MCM胎儿总体预后较好,但应重视出生后随诊.