胎儿硬脑膜窦畸形的产前超声诊断  

Prenatal diagnosis of dural sinus malformation by ultrasound

作　　者：顾莉莉[1] 李胜利[1] 文华轩[1] 欧阳淑媛[2] 

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 [2]南方医科大学附属深圳市妇幼保健院中心实验室,518028

出　　处：《中华医学超声杂志（电子版）》2013年第10期16-19,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金青年科学基金项目(61101026);2011年深圳市科技计划项目(201101013)

摘　　要：目的探讨胎儿硬脑膜窦畸形(DSM)产前超声声像图特征。方法对产前疑诊胎儿脑部异常由南方医科大学附属深圳市妇幼保健院超声会诊的3例胎儿进行颅脑超声及MRI影像检查,并与临床及引产胎儿尸检结果进行对照分析,总结硬脑膜窦畸形产前诊断特点。结果 3例胎儿产前超声均表现为颅内枕骨窦汇区扩大、内可见细密回声流动、伴上矢状窦扩张,其中1例伴窦汇内血栓形成,于扩大的窦汇内可见类圆形高回声团,周边密集点状回声区环绕,彩色多普勒超声未见明显血流信号,超声均诊断为硬脑膜窦畸形(其中1例伴血栓形成)。MRI检查2例,胎儿颅内枕骨窦汇区扩张呈扇状,内呈稍短T1稍短T2信号影,其中1例上矢状窦扩张伴血栓形成,T2WI血栓较脑实质呈中低信号,伴局灶性偏心性稍高信号,诊断为硬脑膜窦畸形伴血栓形成。3例中1例引产尸检显示颅内枕骨窦汇区及上矢状窦后部瘤样扩张,其内血肿形成;2例未尸检。结论胎儿硬脑膜窦畸形典型超声声像图特征为颅内窦汇区扩大,内见密集点状回声,常伴上矢状窦扩张,无明显血流信号,在检出脑中线后方无回声区时应注意识别是否为硬脑膜窦畸形所致。Objective To assess the prenatal features of dural sinus malformation（DSM） by ultrasound.Methods The prenatal ultrasonography and MRI examination were applied in three fetuses who were suspected as brain abnormalities and transferred to Shenzhen Maternity and Child Healthcare Hospital for detailed antenatal ultrasound examination.Comparative analysis was performed on MRI,autopsy and prenatal ultrasonography.The prenatal characteristics were summarized.Results In the sonograms of all three cases,the torcular Herophili and superior sagittal sinus were dilated.No blood flow was detected within or around lesions by color Doppler imaging.Posterior intracranial dual sinus thrombosis was detected in one case.MRI examinations were applied in two fetuses.The results of prenatal ultrasonography were consisted with those of MRI,MRI imaging showed dilated torcular Herophili and superior sagittal sinus with short T 1 and short T 2 signal.The thrombosis was presented as iso-hypointense with focal eccentric hyperintense.One case was undertook autopsy and the result was consisted with the prenatal sonographic findings.Conclusions The typical sonographic features of DSM is dilated torcular Herophili and superior sagittal sinus with no blood flow in color Doppler imaging.DSM should be excluded when anechoic area was detected at the rear part of midline.

关 键 词：超声检查 产前 胎儿 血管畸形 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]