胎儿颅脑幕上常见囊性病变产前超声诊断  

Prenatal Ultrasound Diagnosis of Common Cystic Lesions Above the Fetal Cranial Tentorium

作　　者：贾梦 闫亚妮[1] 李云桃[1] 杨振娟[1] 薛小伟[1] 裴秋艳 Jia Meng;Yan Yani;Li Yuntao;Yang Zhenjuan;Xue Xiaowei;Pei Qiuyan(Department of Obstetrics and Gynecology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院妇产科,北京市100044 [2]青岛大学附属妇女儿童医院妇产超声科

出　　处：《中国超声医学杂志》2024年第11期1277-1280,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的总结胎儿颅脑幕上常见囊性病变的超声特征及发病部位,对囊性病变进行分类,寻找合适的扫查切面。方法回顾分析560例胎儿颅脑幕上囊性病变,根据发病部位和超声特点对病灶进行分类和诊断。结果颅脑幕上囊性病变分为三大类。生理性腔隙异常扩大:颅脑横切面及正中矢状切面表现为腔隙大于正常值上限,大部分预后良好。②特定发病部位囊性病变:颅脑横切面及冠状切面表现为透声好无回声,除Galen静脉瘤外,余囊性病变CDFI均未见血流信号,Galen静脉瘤预后差,余囊性病变预后良好。③无特定发病部位囊性病变:超声需要多切面扫查,脑裂畸形和孔洞脑预后差,蛛网膜囊肿预后良好。结论生理性腔隙病变多位于脑中线区,结合颅脑正中矢状切面进行诊断。特定发病部位的囊性病变结合颅脑冠状面进行诊断。两者预后良好。无特定发病部位囊性病变需多切面扫查,除蛛网膜囊肿外,多数脑实质受累,预后差。Objective To summarize the ultrasonic features and locations of supratentorial cystic lesions,classify the lesions,identify appropriate scanning planes.Methods The sonographic characteristics of 560 fetal supratentorial cystic lesions were reviewed,classification and diagnosis of cystic lesions was based on their ultrasonic features and locations.Results Cranial supratentorial cystic lesions were categorized into three types.①Physiological enlargement of cavities.Ultrasound findings in the transverse and mid-sagittal sections revealed that these cavities exceed the normal upper limit.Most fetuses had a favorable prognosis.②Cystic lesions with specific onset sites.On transverse and coronal brain scans,these lesions demonstrated good acoustic transparency with no echoes,and aside from Galen's vein aneurysms,no blood flow signals were detected on CDFI.The prognosis for Galen's vein aneurysms was poor,the prognosis of residual cystic lesions was good.③Cystic lesions without specific onset sites.Ultrasound imaging required multiple sectional scans.Schizencephaly and porencephaly had poor prognosis,while arachnoid cyst had a good prognosis.Conclusions Physiological lacunar lesions frequently occur in the midline region of the brain and are diagnosed in conjunction with the midline sagittal section of the cranium.Cystic lesions at specific locations require localization and diagnosis in conjunction with the coronal plane of the cranium.Both conditions have a favorable prognosis.Cystic lesions without specific onset sites require multi sectional scanning.Except for arachnoid cysts,most brain parenchyma is affected and the prognosis is poor.

关 键 词：胎儿 颅脑幕上囊性病变 产前超声特征 预后 

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]