彩色多普勒超声诊断胎儿Galen静脉血管瘤

The diagnosis of vein of Galen aneurysmal malformation by CDFI in fetuses

目的探讨彩色多普勒超声在产前诊断胎儿Galen静脉血管瘤的临床价值。方法对我院2007年1月至2008年10月超声诊断的3例胎儿Galen静脉血管瘤的超声声像图、并发症与随访结果进行回顾性分析。结果超声声像图显示3例胎儿在丘脑后下方、小脑上方有一无回声囊性结构,彩色多普勒超声提示无回声区内为高速低阻血流信号,与颅底动脉环间可见多条血管分支相通;脑室系统均未见扩大;胎儿心胸比增大,其中2例伴有上腔静脉内径增宽、三尖瓣反流;2例伴有胸腹水,1例全身皮肤水肿伴羊水过多,1例脐动脉舒张期血流反向。随访:1例胎儿出生当日死亡,1例出生后1个月死于心力衰竭,1例引产。结论胎儿Galen静脉血管瘤预后差。彩色多普勒超声检查是诊断胎儿Galen静脉血管瘤的首选影像学方法,具有重要的临床诊断价值。

Objective To study the clinical value of color Doppler flow imaging （CDFI） in fetuses with vein of Galen aneurysmal malformation （ VGAM ）. Methods The retrospective analysis on ultrasonic view, complication and follow-up visit in three cases which were diagnosed as VGAM was performed from January 2007 to October 2008. Results An intracerebral echoless cyst could be visualized in all the three cases,in which ＂high-speed and low-resistance＂ blood signal could be detected by CDFI. There was direct communication between the vein of Galen and several basis cranii cerebral arteries without cerebral ventricle dilation. The dilated heart-breast rate could be visualized in all the three cases, two of which complicating with the dilation of superior vena cava （SVC） and tricuspid regurgitation （TR） ; two of which complicating with pleural fluid and abdominal dropsy ; one of which complicating with edema of skin and polyhydramnios; one of which complicating with reversing blood signal of umbilical artery （UA） in diastolic phase. One case died on the birth day during follow-ups, one died of heart failure after one month postnatal while the other one induced abortion. Conclusions The VGAM in fetuses has poor prognosis. The CDFI plays an important role in the clinical diagnosis of VGAM, which may be used for the first choice in examining VGAM in fetuses.