产前超声结合磁共振成像诊断Galen静脉动脉瘤样畸形  

Prenatal diagnosis of ultrasound and MRI in the vein of Galen aneurysmal malformation

作　　者：伍玉晗[1] 陈欣林[1] 赵胜[1] 刘丽萍[1] 刘沁[1] 张莉[1] 王玉波[1] Wu Yuhan;Chen Xinlin;Zhao Sheng;Liu Liping;Liu Qin;Zhang Li;Wang Yubo(Department of Ultrasound,Maternal and Child Heath Hospital of Hubei,Wuhan,430070,China)

机构地区：[1]湖北省妇幼保健院超声诊断科,武汉430070

出　　处：《中华医学超声杂志（电子版）》2017年第11期857-861,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨产前超声及磁共振成像在胎儿脑Galen静脉动脉瘤样畸形中的诊断价值。方法对17例于2011年1月至2016年12月在湖北省妇幼保健院产前超声及磁共振成像检查诊断为Galen静脉动脉瘤样畸形胎儿的超声及磁共振图像特征和临床结局进行总结研究。结果孕晚期产前超声发现并诊断为Galen静脉动脉瘤样畸形的胎儿15例,均表现为中线区的薄壁囊性无回声,彩色多普勒血流成像可记录到动静脉瘘频谱和胎儿静脉窦不同程度扩张;颅脑实时三维成像可对血管构架进行成像,显示供血动脉与扩张的Galen静脉间的关系。MRI特征性表现为大脑中线处、大脑大静脉池区、四叠体池区扩张的静脉瘤,邻近解剖部位见走行迂曲的流空血管影。17例胎儿中超声未诊断Galen静脉动脉瘤样畸形2例;MRI辅助诊断7例。产前超声检查后17例胎儿中15例因孕妇选择终止妊娠引产,2例出生后新生儿期死亡。结论 Galen静脉动脉瘤样畸形具有典型的超声声像图表现,MRI可显示神经系统发育及受损情况,有助于对超声疑诊病例进行辅助诊断。超声与MRI联合应用可更准确、更全面地观察Galen静脉动脉瘤样畸形的病变特点,早期诊断相关并发症。Objective To explore the clinical value of prenatal ultrasound and magnetic resonance imaging in the vein of Galen aneurysmal malformation.Methods The ultrasonographic characteristics and magnetic resonance imaging features of 17 fetuses who were diagnosed as the vein of Galen aneurysmal malformation in Maternal and Child Heath Hospital of Hubei from January 2011 to December 2016 were compared.Results Fifteen cases of Galen aneurysmal malformation.Were diagnosed by prenatal ultrasound during the third trimester.The sonographic feature was a hypoechogenic structure located in the middle line with arteriovenous fistula waveform in doppler analysis,and the cerebral venous sinus of all cases were dilated.Real time three dimensional power doppler can display the angioarchitecture and the communications between widened vascular sinus.MRI feature was the expansion of venous aneurysm located in the middle line,greater cerebral venous pool and quadrigeminal area and tortuous flow void vessels.Among 17 cases,2 cases of Galen venous aneurysm malformation were misdiagnosed and 7 cases were diagnosed by MRI.There were 15 terminations and 2 neonatal died after birth.Conclusions Galen aneurysmal malformations have typical sonographic findings,and MRI can show neurologic development and impairment.Combined application of ultrasound and magnetic resonance imaging technology can more accurately and comprehensively observe the pathological features of Galen venous aneurysm malformation and diagnose the related complications early.

关 键 词：超声检查 产前 胎儿 磁共振成像 GALEN静脉动脉瘤样畸形 

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