中华医学超声杂志(电子版)
中華醫學超聲雜誌(電子版)
중화의학초성잡지(전자판)
CHINESE JOURNAL OF MEDICAL ULTRASOUND(ELECTRONICAL VISION)
2013年
10期
16-19
,共4页
顾莉莉%李胜利%文华轩%欧阳淑媛
顧莉莉%李勝利%文華軒%歐暘淑媛
고리리%리성리%문화헌%구양숙원
超声检查,产前%胎儿%血管畸形
超聲檢查,產前%胎兒%血管畸形
초성검사,산전%태인%혈관기형
Ultrasonography,prenatal%Fetus%Vascular malformations
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。
目的探討胎兒硬腦膜竇畸形(DSM)產前超聲聲像圖特徵。方法對產前疑診胎兒腦部異常由南方醫科大學附屬深圳市婦幼保健院超聲會診的3例胎兒進行顱腦超聲及MRI影像檢查,併與臨床及引產胎兒尸檢結果進行對照分析,總結硬腦膜竇畸形產前診斷特點。結果3例胎兒產前超聲均錶現為顱內枕骨竇彙區擴大、內可見細密迴聲流動、伴上矢狀竇擴張,其中1例伴竇彙內血栓形成,于擴大的竇彙內可見類圓形高迴聲糰,週邊密集點狀迴聲區環繞,綵色多普勒超聲未見明顯血流信號,超聲均診斷為硬腦膜竇畸形(其中1例伴血栓形成)。MRI檢查2例,胎兒顱內枕骨竇彙區擴張呈扇狀,內呈稍短T1稍短T2信號影,其中1例上矢狀竇擴張伴血栓形成,T2WI血栓較腦實質呈中低信號,伴跼竈性偏心性稍高信號,診斷為硬腦膜竇畸形伴血栓形成。3例中1例引產尸檢顯示顱內枕骨竇彙區及上矢狀竇後部瘤樣擴張,其內血腫形成;2例未尸檢。結論胎兒硬腦膜竇畸形典型超聲聲像圖特徵為顱內竇彙區擴大,內見密集點狀迴聲,常伴上矢狀竇擴張,無明顯血流信號,在檢齣腦中線後方無迴聲區時應註意識彆是否為硬腦膜竇畸形所緻。
목적탐토태인경뇌막두기형(DSM)산전초성성상도특정。방법대산전의진태인뇌부이상유남방의과대학부속심수시부유보건원초성회진적3례태인진행로뇌초성급MRI영상검사,병여림상급인산태인시검결과진행대조분석,총결경뇌막두기형산전진단특점。결과3례태인산전초성균표현위로내침골두회구확대、내가견세밀회성류동、반상시상두확장,기중1례반두회내혈전형성,우확대적두회내가견류원형고회성단,주변밀집점상회성구배요,채색다보륵초성미견명현혈류신호,초성균진단위경뇌막두기형(기중1례반혈전형성)。MRI검사2례,태인로내침골두회구확장정선상,내정초단T1초단T2신호영,기중1례상시상두확장반혈전형성,T2WI혈전교뇌실질정중저신호,반국조성편심성초고신호,진단위경뇌막두기형반혈전형성。3례중1례인산시검현시로내침골두회구급상시상두후부류양확장,기내혈종형성;2례미시검。결론태인경뇌막두기형전형초성성상도특정위로내두회구확대,내견밀집점상회성,상반상시상두확장,무명현혈류신호,재검출뇌중선후방무회성구시응주의식별시부위경뇌막두기형소치。
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 lfow 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 T1 and short T2 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 lfow in color Doppler imaging. DSM should be excluded when anechoic area was detected at the rear part of midline.