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目的建立超声检测不同孕期胎儿脊髓圆锥末端至最末尾骨远端距离的正常值,评估其在脊髓拴系诊断中的价值。方法研究对象包括400例正常胎儿及8例脊髓拴系的胎儿。随机选择40例胎儿,进行医师内及医师间测量结果的信度分析。建立胎儿脊髓圆锥末端至最末尾骨远端距离的正常值范围,比较正常组及脊髓拴系组的差别。结果 (1)400例胎儿中,脊髓圆锥末端至最末尾骨远端的显示率为91%。(2)相同及不同医师测量的重复性良好(ICC:0.990~0.998),其95%一致性界限分别为:-2.2~2.6mm和-3.7~3.1mm。(3)胎儿脊髓圆锥末端至最末尾骨远端距离与孕周呈线性正相关关系,相关方程为:脊髓圆锥末端至最末尾骨远端距离=-23.09+2.39孕周(r=0.965,P<0.001)。(4)8例脊髓拴系组的脊髓圆锥末端至最末尾骨远端距离与正常组相比明显缩短(P<0.001)。结论超声测量胎儿脊髓圆锥末端至最末尾骨远端距离简便可行,这一参数有助于产前诊断胎儿脊髓拴系。
OBJECTIVE To establish the normal value of the distance from the conical end to the distal end of the distal end of the fetal spinal cord in different stages of pregnancy by ultrasound and evaluate its value in the diagnosis of tethered cord. Methods The study included 400 normal fetuses and 8 fetuses tethered to the spinal cord. Forty randomly selected fetuses were analyzed for reliability of measurements between physicians and physicians. The normal range of the distance from the conical end of the fetal spinal cord to the distal end of the distal bone was established, and the differences between the normal group and the tethered group were compared. Results (1) In 400 fetuses, the display rate of conus distal to distal end of spinal cord was 91%. (2) Good repeatability was measured by the same and different physicians (ICC: 0.990-0.998) with 95% agreement limits of -2.2-2.6 mm and -3.7-3.1 mm, respectively. (3) There was a linear positive correlation between the distal end of the fetal spinal cord and the end of the coccyx, and the gestational age. The correlation equation was: the distance from the conical end of the spinal cord to the distal end bone = -23.09 + 2.39 gestational weeks (r = 0.965, P <0.001). (4) The distance from the conical end of the spinal cord to the distal end of the tailbone in the tetanus group was significantly shorter than that of the normal group (P <0.001). Conclusion Ultrasound measurement of fetal spinal conical tip to the distal end of the distal bone distance simple and feasible, this parameter is conducive to prenatal diagnosis of tethered fetus and spinal cord.