目的 探讨彩色多普勒超声、核 磁共振(MRI)检查对胎儿中枢神经系统畸 形的诊断效能。方法 选取2014年1月至 2018年1月于我院100例疑似怀有中枢神经 系统畸形胎儿孕妇作为研究对象，以产后 胎儿检查或尸检结果作为金标准，比较不 同检查方法对诊断中枢神经系统畸形的检 出率、灵敏度和特异度，并比较畸形胎儿 在不同检查方法中的影像学图像表现。 结果 超声检查诊断小头畸形符合率显著 较高，而MRI诊断脑发育不良和第四脑室 孔闭塞综合征符合率显著较高(P<0.05)； MRI单项以及联合超声检查诊断胎儿中枢 神经系统畸形的灵敏度均明显高于超声检 查(P<0.05)；MRI图像质量评分显著高于 超声(P<0.05)；在彩色多普勒超声检查 中，脑膨出胎儿其颅骨可表现为高回声， 且呈连续性中断，在小头畸形胎儿中，胎 儿头围明显减小；脉络丛囊肿胎儿脉络丛 区域显示圆形无回声区，胼胝体发育不全 在超声检查中的冠状切面和矢状切面未能 显示，超声检查对于脑发育不良未能明 确显示，部分可见头部围度显著减小。 在MRI检查中，胎儿可表现为脑室枕角扩 大，侧脑室呈“水滴”状异常改变，正矢 状位、冠状位均未见胼胝体，可清晰显示 小脑及蚯部，而对于小头畸形MRI检查不 可检出。结论 彩色多普勒超声和MRI对胎 儿中枢神经系统畸形的诊断符合率相类 似，但MRI图像质量更高，且两者结合诊 断灵敏度更高，故可将该两种检查方法联 合起来，互为补充，进而更有利于胎儿中 枢神经系统畸形的诊断。

Objective To investigate the diagnostic efficacy of color Doppler ultrasound and magnetic resonance imaging (MRI) examination on malformation of fetal central nervous system. Methods 100 pregnant women suspected whose fetus had malformation of central nervous system treated in our hospital from January 2014 to January 2018 were enrolled. The postpartum fetal examination or result of autopsy were used as the gold standard to compare the detection rate, sensitivity and specificity of different examination for the diagnosis of malformation of central nervous system. And the imaging features of deformed fetuses in different examination were compared. Results The coincidence rate of ultrasonography in the diagnosis of microcephaly was significantly higher, and the coincidence rate of MRI in diagnosis of dysplasia of brain and occlusion syndrome of the fourth ventricle was significantly higher (P<0.05). The sensitivity of MRI alone and MRI combined ultrasonography in the diagnosis of malformation of fetal central nervous system was significantly higher than that of ultrasonography (P<0.05). The image quality of MRI was significantly higher than that of ultrasound (P<0.05). In color Doppler ultrasonography, the skull of the fetus with encephalocele showed high echo with continuous interruption.In the microcephaly fetus, the fetal head circumference is significantly reduced.In fetus with cyst of choroid plexus,the choroid plexus showed a circular anechoic area,coronal section and sagittal section in agenesis of the corpus callosum in the ultrasound examination failed to show,ultrasound examination did not clearly show brain dysplasia, and the head circumference partly was significantly reduced. In the MRI examination, the fetus can be characterized by enlarged occipital angle of the ventricle, abnormal changes in the lateral ventricle in the form of "drops of water", corpus callosum was not observed in the sagittal and coronal positions, and the cerebellum and thalamencephalon were clearly displayed,but MRI can not detect microcephaly. Conclusion Color Doppler ultrasound and MRI have similar diagnostic rates for malformation of fetal central nervous system. However, the image quality of MRI is higher, and the sensitivity of combination of two examinations is higher. Therefore, the two examinations can be combined to complement each other, which is more beneficial for the diagnosis of malformation of fetal central nervous system.v