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目的探讨产前三维超声在胎儿颅内脑中线囊性病变诊断中的应用价值。方法回顾性分析2015年1月-2016年8月该院产前三维超声检查发现、会诊确诊合并胎儿颅内脑中线囊性病变的131例患儿三维超声结果。结果产前三维超声结果显示,55例(42%)为颅内脑中线处正常腔室扩张,其中后颅窝池扩张25例、第三脑室扩张9例、韦氏腔未闭或扩张7例、中间帆腔扩张8例、四叠体池扩张3例、上矢状窦扩张3例;蛛网膜囊肿20例,其中位于大脑半球间裂14例(合并胼胝体缺失或部分缺失4例),位于后颅窝6例(合并其他系统畸形引产3例,单纯后颅窝池蛛网膜囊肿3例);无叶全前脑34例,第四脑室囊状扩张合并小脑蚓部发育不全(Dandy-Walker综合征)5例,侧脑室前角相通6例,Blake窝囊肿11例。结论三维超声成像可较二维超声直观显示胎儿颅内矢状面结构,明确病变部位及与周围脑实质关系,从而判断病灶来源和性质,更有利于产前咨询和临床决策。
Objective To investigate the value of prenatal three-dimensional ultrasound in the diagnosis of intracranial cystic lesions in the fetus. Methods Retrospective analysis from January 2015 to August 2016, prenatal three-dimensional ultrasound examination of the hospital found that consultation diagnosis of fetal intracranial brain central line cystic lesions in 131 cases of three-dimensional ultrasound results. Results The results of prenatal three-dimensional ultrasound showed that 55 cases (42%) were normal dilatation of the midline of intracranial brain, including 25 cases of posterior fossa dilatation, 9 cases of third ventricle dilation, 7 cases of Wechsler’s orbital closure or 7 cases of dilatation , Middle sagittal expansion in 8 cases, quadrigeminal pool expansion in 3 cases, superior sagittal sinus expansion in 3 cases; arachnoid cyst in 20 cases, of which located in the cerebral hemispheric fissure in 14 cases (with corpus callosum or partial deletion in 4 cases), located 6 cases of posterior fossa (3 cases of abortion induced by other system abnormalities, 3 cases of posterior fossa pool arachnoid cyst); 34 cases of non-leaf forebrain, 4 cases of dilated cerebellar dilatation and cerebellar vermis (Dandy-Walker Syndrome) in 5 cases, lateral ventricular anterior communicating angle in 6 cases, Blake’s nest cyst in 11 cases. Conclusion Three-dimensional ultrasound imaging can visualize fetal intracranial sagittal structures more clearly than 2D ultrasound, clarify the relationship between lesions and surrounding brain parenchyma, so as to determine the origin and nature of the lesion, which is more conducive to prenatal counseling and clinical decision-making.