胎儿豆纹动脉血管病的产前超声诊断  

Sonographic lenticulostriate vasculopathy in fetus

作　　者：黄怡 李胜利[1] 文华轩[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院超声科,518028

出　　处：《中华医学超声杂志（电子版）》2013年第9期758-762,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金面上项目(81270707);国家自然科学基金青年基金项目(60671043);2011年深圳市科技计划项目(201101013)

摘　　要：目的探讨胎儿豆纹动脉血管病的产前超声声像图特征及其意义。方法对2012年11月至2013年4月在深圳市妇幼保健院行产前血清学抗体检查、超声及磁共振检查诊断的3例双侧大脑豆纹动脉血管病胎儿的超声影像学特征进行总结,结合新生儿临床及致畸病原体感染检查结果进行综合诊断分析。结果产前与产后超声及临床检查结果:(1)产前超声检查:3例胎儿宫内生长受限,心包积液;其中2例(例1和2)侧脑室轻度扩张和室管膜下少量出血;1例(例3)双侧脑室扩张,左侧脑室内出血,伴二、三尖瓣反流和双眼白内障,产前超声均诊断为胎儿豆纹动脉血管病。(2)孕妇血清抗体检测:3例中2例(例1和3)孕妇致畸病原体血清抗体检测结果未见异常,1例孕妇(例2)致畸病原体血清抗体检测阳性。(3)新生儿相关检查:1例(例3)新生儿致畸病原体血清抗体检测呈阳性,双眼晶状体混浊,听力损伤;1例(例3)新生儿致畸病原体血清抗体检测呈阳性,双侧视网膜出血,高胆红素血症,窦性心率过缓。(4)引产胎儿未进行尸检。结论产前超声声像图可清楚显示胎儿豆纹动脉血管病,产前超声提示豆纹动脉血管病而无其他异常超声表现,孕妇致畸病原体血清抗体检测阴性的胎儿其宫内感染的可能性较大。Objective To explore the value of prenatal diagnosis and sonographic features of lenticulostriate vasculopathy (LSV). Methods Prenatal ultrasonographic features of three cases of fetal lenticulostriate vasculopathy were retrospectively analysed associated with maternal TORCH screen, fetal magnetic resonance imaging, neonatal physical examination and TORCH screen. Results Prenatal sonographic diagnosis of case 1 demonstrated fetal LSV as well as fetal growth restriction (FGR), periventricular hemorrhage, mitral and tricuspid regurgitation, hydropericardium and catatact. Prenatal sonographic diagnosis of case 2 demonstrated fetal LSV, FGR, periventricular hemorrhage, mitral and tricuspid regurgitation. Prenatal sonographic diagnosis of case 3 showed fetal LSV and intraventricular hemorrhage. Maternal TORCH screens of case 1 and case 3 was negative, while in case 2 was positive. Neonatal examinations of case 1 showed cataract, hearing impairment and congenital infection. Case 3 showed prompted retinal hemorrhage, sinus bradycardia, hyperbilirubinemia and congenital infection. In case 2, maternal teratogenic pathogen screen was positive and the baby did not survive because the mother decided to stop pregnancy in 34 weeks. Conclusions Fetal LSV could be imaged by prenatal ultrasonography. Fetal LSV might indicate intrauterine infection when other abnormalities were accompanied. Ultrasound might be useful for the cases with negative maternal TORCH screen results.

关 键 词：超声检查 产前 胎儿 脑血管基底神经节疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学]