目的:研究正常发育的冠部长度(CRL)为10至84mm的胚胎和胎儿的中枢神经系统(CNS)的超声特征,利用高频经阴道探针结合各种三维(3D)成像模式。
方法:从2020年1月至2021年2月,招募了210个正常发育的胚胎和早期妊娠胎儿,并根据其孕龄进行分类。使用高频经阴道换能器进行2D和3D超声检查,并保存了3D图像。然后使用多种3D技术处理这些图像,比如高清实时剪影,OmniView,还有TUI.此外,通过后fonal门测量了and的周长。
结果:从胚胎发育的10mmCRL阶段开始,高频经阴道三维超声成像能够清晰地显示前脑,中脑,菱形脑.在16-22mmCRL阶段观察到菱形脑的显着变化,包括桥脑弯曲和小脑原基的可视化。在23-40mmCRL时,有明显的脑桥弯曲,和发育中的小脑,第四脑室,可以观察到第四脑室(4thVCP)的脉络丛。菱形脑的顶部被第4个VCP划分为位于鼻端的前膜区(AMA)和位于尾端的后膜区(PMA)。此外,最初的Blake\的小袋(BP)是可识别的。在41-84毫米CRL的胎儿中,AMA的大小随着蚯蚓的发育而逐渐减小。从矢状中看,第四VCP的方向似乎从垂直于神经管的长轴转变为平行于它。此外,CRL与椎骨周长之间存在显着相关性。
结论:使用经阴道三维超声扫描,可以详细观察7至136周正常胚胎发育期间中枢神经系统(CNS)的形态变化。该技术可以帮助准确表征CNS的胚胎起源。本文受版权保护。保留所有权利。
To study the ultrasonographic features of the central nervous system (CNS) in normally developing embryos and fetuses with a crown-rump length (CRL) of 10-84 mm, utilizing a high-frequency transvaginal probe in conjunction with various three-dimensional (3D) imaging modes.
From January 2020 to February 2021, 210 normally developing embryos and fetuses in early pregnancy were enrolled and classified based on their gestational age. A high-frequency transvaginal transducer was used to perform 2D and 3D ultrasounds, and the 3D images were saved. These images were then processed using multiple 3D technologies, such as HD live silhouette, OmniView, and TUI. Additionally, the circumference of the vermis was measured through the posterior fontanelle.
Beginning at the 10 mm CRL stage of embryonic development, high-frequency transvaginal 3D ultrasound imaging was able to clearly visualize the prosencephalon, mesencephalon, and
rhombencephalon. Notable changes were observed in the
rhombencephalon during the 16-22 mm CRL stage, including the visualization of the pontine flexure and cerebellar primordium. At 23-40 mm CRL, there was a distinct pontine flexure, and the developing cerebellum, the fourth ventricle, and choroid plexus of the fourth ventricle (4th VCP) could be observed. The roof of the
rhombencephalon was partitioned by the 4th VCP into the anterior membranous area (AMA) located rostrally and the posterior membranous area situated caudally. Additionally, the original Blake\'s pouch was identifiable. Among fetuses measuring 41-84 mm CRL, the AMA progressively decreased in size as the vermis developed. From the mid-sagittal view, the orientation of the 4th VCP seemed to shift from being perpendicular to the neural tube\'s long axis to being parallel to it. Furthermore, there was a significant correlation between CRL and vermis circumference.
Using three-dimensional transvaginal ultrasound scanning, detailed visualization of the morphological changes in the CNS during normal embryonic development from 7 to 13+6 weeks is possible. This technology can aid in accurately characterizing the embryonic origin of the CNS.