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目的评价三维立体超声容积测量功能(VOCAL)对胎儿小脑蚓部发育的监测价值。方法前瞻性地对730例孕18～35w胎儿应用腹部三维立体超声容积探头,在胎头小脑蚓部的正中矢状切面,测量胎儿小脑蚓部面积,储存在仪器上,由专人应用其三维立体超声的容积测量功能(Virtual Organ Computer aided analysis,VOCAL)测量胎儿小脑蚓部体积,获得不同孕周正常值,并发现异常儿。结果胎儿小脑蚓部体积随孕周增加而增大呈正相关(r=0.86,P<0.05),发现异常儿10例,其中小脑蚓部缺如9例(6例系Dandy-Walker综合征,3例系全前脑并多发畸形),小脑蚓部发育不良1例。结论三维立体超声VOCAL能够克服二维超声扫查难以获取的胎头小脑蚓部正中矢状切面,有助于揭示正常胎儿小脑蚓部的发育规律,并发现异常的小脑蚓部,使宫内评价胎儿小脑蚓部发育成为可能。
Objective To evaluate the value of three dimensional ultrasound volume measurement (VOCAL) on the development of fetal cerebellar vermis. Methods 730 cases of pregnant 18 ~ 35w fetal prospective application of abdominal three-dimensional ultrasound volume probe in the median fetal sagittal section of cerebellar vermis to measure the area of fetal cerebellar vermis, stored on the instrument by the hand of its three-dimensional Ultrasound volume measurement function (Virtual Organ Computer aided analysis, VOCAL) measurement of fetal cerebellar vermis volume, to obtain normal values of different gestational weeks, and found abnormalities. Results Fetal cerebellar vermis volume was positively correlated with the increase of gestational age (r = 0.86, P <0.05). There were 10 cases with abnormalities in the cerebellum, including 9 cases without cerebellar vermis (6 cases with Dandy-Walker syndrome, 3 Cases of the entire forebrain and multiple deformities), cerebellar vermis dysplasia in 1 case. Conclusion The three-dimensional ultrasound VOCAL can overcome the medium sagittal section of the vermis of the fetal cerebellum which is difficult to obtain by two-dimensional ultrasonography. It is helpful to reveal the law of development of the vermis in the normal fetal cerebellum and to find abnormal cerebellar vermis to make intrauterine evaluation Fetal cerebellar vermis development possible.