胎儿巨大蛛网膜囊肿并文献复习  

Fetal giant arachnoid cysts:a case report and literature review

作　　者：吴少敏 张世豪[2] 刘炳光[3] 李婵[1] 尹嘉敏 郑昌业 黄素然[4] Wu Shaomin;Zhang Shihao;Liu Bingguang;Li Chan;Yin Jiamin;Zheng Changye;Huang Suran(Prenatal Diagnosis Center of the Tenth Affiliated Hospital,Southern Medical University(Dongguan People's Hospital),Dongguan Key Laboratory of Major Diseases in Obstetrics and Gynecology,Dongguan 523000,Guangdong Province,China;Department of Pathology of the Tenth Affiliated Hospital,Southern Medical University(Dongguan People's Hospital),Dongguan Key Laboratory of Clinical Pathology,Dongguan 523000,Guangdong Province,China;Department of Radiology,Shenzhen Maternity and Child Healthcare Hospital,Shenzhen 518100,Guangdong Province,China;Department of Obstetrics,The Tenth Affiliated Hospital,Southern Medical University(Dongguan People's Hospital),Dongguan Key Laboratory of Major Diseases in Obstetrics and Gynecology,Dongguan 523000,Guangdong Province,China;Department of Radiology,the Tenth Affiliated Hospital,Southern Medical University(Dongguan People's Hospital),Dongguan Imaging and Artificial Intelligence Medical Key Laboratory,Dongguan 523000,Guangdong Province,China)

机构地区：[1]南方医科大学第十附属医院(东莞市人民医院)产前诊断中心,东莞市妇产科重大疾病重点实验室,东莞523000 [2]南方医科大学第十附属医院(东莞市人民医院)病理科,东莞市临床病理重点实验室,东莞523000 [3]深圳市妇幼保健院放射科,深圳518100 [4]南方医科大学第十附属医院(东莞市人民医院)产科,东莞市妇产科重大疾病重点实验室,东莞523000 [5]南方医科大学第十附属医院(东莞市人民医院)放射科,东莞市影像与人工智能医疗重点实验室,东莞523000

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第4期390-397,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：广东省基础与应用基础研究基金联合基金项目(2023A1515140149)。

摘　　要：目的探讨胎儿蛛网膜囊肿(AC)影像学表现、遗传学特征及病理特点。方法选择2023年7月在东莞市人民医院诊治的1例胎龄为32周时产前胎儿超声结果提示巨大AC胎儿(胎儿1)为研究对象。采用回顾性分析法,对引产前胎儿超声及胎儿头颅MRI检查结果与引产后胎儿遗传学检测及解剖结果进行分析。以“蛛网膜”“胎儿”“arachnoid cyst”“fetus”“fetal”“intracranial”为中、英文关键词,在中国知网、万方数据知识服务平台及Pub Med、Web of Science数据库中,检索与胎儿AC相关研究文献。本次文献检索时间设定为上述数据库建库至2024年1月。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》,并经南方医科大学第十附属医院(东莞市人民医院)伦理委员会批准(审批文号:IRB2023-WZ-156)。孕妇对诊断及治疗均知情同意。结果①对孕妇孕龄为32孕周时,产前胎儿超声检查结果提示,胎儿1发育相当于胎龄为32周,右侧蛛网膜可见一囊性占位(9.7 cm×3.3 cm),边界清、透声好,囊性包括内未见明显血流信号,双侧大脑半球不对称,左侧大、右侧小,脑中线向左侧偏移,左侧脑室最大测量值为1.4 cm,拟诊为右侧AC,左侧脑室增宽。②孕妇孕龄为32孕周时,胎儿头颅MRI检查结果显示:胎儿1右侧大脑半球蛛网膜间隙整体增宽呈新月状,轴位测量最大面积为10.6 mm×2.3 mm,大脑右侧占位大脑镰整体左移,脑实质未见异常信号,双侧大脑半球不对称,右侧半球较对侧体积小,脑沟双侧不对称,右侧部分脑沟变浅,左侧脑室最大径为1.6 cm,提示右侧AC、右侧大脑发育较对侧延迟、左侧脑室增宽。③胎儿1尸体解剖显示:女性胎儿,大脑镰左移,右外侧蛛网膜与周围组织间少量积液。双侧大脑稍不对称,右侧大脑体积较左侧稍小;脑膜组织切片经HE染色,高倍镜下显示硬脑膜和蛛网膜分离,形成腔隙。胎儿其他器官�Objective To explore the imaging manifestations,genetic characteristics,and pathological features of fetal arachnoid cysts(AC).Methods A case of a 32-week-gestational-age fetus with a prenatal ultrasound showing a large AC treated at Dongguan People's Hospital in July 2023 was selected in the study.A retrospective analysis was conducted on the fetal ultrasound examination and fetal head MRI examination results before termination of pregnancy,as well as the genetic testing and pathological autopsy results after termination of pregnancy.The literature on fetal AC was retrieved from the China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,and Pub Med,Web of Science databases using the Chinese and English keywords"arachnoid cyst""fetus""fetal""intracranial".The literature search time was set from the establishment of the above databases to January 2024.This study followed the procedures in accordance with the 2013 revision of the Declaration of Helsinki by the World Medical Association and adhered to the ethical standards set by the Ethics Committee of the Tenth Affiliated Hospital of Southern Medical University(Dongguan People's Hospital)(Approval No.IRB2023-WZ-156).The pregnant woman gave informed consent for the diagnosis and treatment.Results①The fetus's ultrasound examination at 32 weeks of gestation indicated that the fetal development was equivalent to 32 weeks,with a 9.7 cm×3.3 cm cystic occupancy in the right arachnoid,clear boundaries,good transmission,no obvious blood flow signals,asymmetrical bilateral cerebral hemispheres,the left side larger than that of the right,the midline of the brain shifted to the left,and the maximum measurement of the left ventricle was 1.4 cm,tentatively diagnosed as right AC,and dilatation of the left ventricle.②The fetus's head MRI at 32 weeks of gestation showed:the arachnoid space of the right cerebral hemisphere of the fetus was overall widened in a crescent shape,with the maximum diameter measured in

关 键 词：蛛网膜囊肿 超声检查 磁共振成像 病理 胎儿 

分 类 号：R714.5[医药卫生—妇产科学]