胎儿脑皮层发育畸形的超声特征及其与MRI的对照分析  

Ultrasonic Features of Fetal Malformation of Cortical Development and Comparative Analysis with MRI

作　　者：张书杰[1] 姜凡[1] 罗平[1] 顾莉莉[1] 谭捷[1] 张贤月 Zhang Shujie;Jiang Fan;Luo Ping;Gu Lili;Tan Jie;Zhang Xianyue(Department of Ultrasound,The Second Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院超声诊断科,合肥市230601

出　　处：《中国超声医学杂志》2022年第7期831-835,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 总结胎儿脑皮层发育畸形的超声特征,评价超声及MRI在该病中的诊断价值。方法 通过对10例脑皮层发育畸形胎儿的超声资料及相关资料进行回顾性分析。结果 无脑回-巨脑回畸形的超声特征为:大脑外侧裂形态异常、脑沟脑回发育晚于相应孕周、侧脑室增宽;半侧巨脑畸形的超声特征为:两侧颅骨、大脑半球、大脑外侧裂、脑沟、脑回均不对称,一侧大脑半球增大伴脑回明显增厚;多小脑回畸形的超声特征为:脑叶可见多个锯齿状细小脑回,部分可伴有大脑外侧裂异常及顶枕沟、距状沟等发育晚于孕周;脑裂畸形的超声特征为:脑实质内可见裂口连于侧脑室至蛛网膜下腔。超声漏诊2处脑裂畸形,而MRI检出全部畸形。结论 胎儿脑皮层发育畸形有特征性的超声表现,产前超声是其重要的筛查手段,但部分声像图不典型,应及时行MRI检查明确诊断。Objective To summarize the ultrasonic characteristics of fetal malformation of cortical development(MCD), and evaluate the diagnostic value of ultrasound and MRI in this disease. Methods The ultrasound data and related data of 10 fetuses with MCD were retrospectively analyzed. Results The ultrasonic characteristics of lissencephaly-pachygyria malformation were: abnormal shape of Sylvian fissure(SF), later development of sulci and gyri than the corresponding gestational age, enlarged lateral ventricle.The ultrasonic characteristics of hemimegalencephaly were: asymmetry of bilateral skull, cerebral hemisphere, Sylvian fissure, sulci and gyri, markedly thickened gyri in one enlarged hemisphere. The ultrasonic characteristics of polymicrogyria malformation were: abnormal microgyri in cerebral lobes, some of them might be accompanied by abnormal SF and the development of parieto-occipital fissure(POF) and calcarine fissure(CF) later than the gestational week.The ultrasonic characteristic of schizencephaly was cleft in the brain parenchyma from the lateral ventricle to the subarachnoid space. Ultrasonography missed two sites of schizencephaly, but MRI detected all of them. Conclusions Prenatal ultrasound is an important screening method for fetal MCD, which has characteristic ultrasonic manifestations. However, some of the sonograms are not typical, so MRI examination should be conducted timely to confirm the diagnosis.

关 键 词：产前超声 脑皮层发育畸形 胎儿 MRI 

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]