胎儿室管膜下囊肿的超声诊断及临床结局

Ultrasonic diagnosis and clinical outcome of fetal subependymal cysts

目的探讨胎儿室管膜下囊肿的超声表现、临床结局及预后。方法回顾性分析我院产前超声检出的胎儿室管膜下囊肿135例,分析所有病例声像图表现特点及临床结局。结果囊肿均位于侧脑室前角外侧或侧脑室前角与体部交界处的外侧,壁薄,边界清。单侧发生41例,双侧发生94例。表现为单发囊肿61例,多发或串珠样囊肿74例。其中3例孕妇合并妊娠期高血压疾病,19例合并胎儿异常。成功随访102例,4例因合并严重畸形引产,3例早产(其中1例出生后死亡,2例随访健康),2例胎死宫内,1例合并脑室扩张者随访至2岁智力发育迟缓,余92例随访至2岁均健康发育。结论超声能准确诊断胎儿室管膜下囊肿。排除其他相关异常及合并畸形的单纯室管膜下囊肿,短期预后良好。

Objective To explore ultrasonic appearance, clinical outcome and prognosis of fetal subependymal cysts. Methods Sonographic features and clinical outcome in 135 fetuses with subependymal cysts were analyzed retrospectively. Results All the cysts were located in the lateral region of anterior horn of lateral ventricle or in the lateral region between anterior horn and body of lateral ventricle. The cysts had thin walls and clear boundaries. Forty-one cases were located in unilateral ventricle, and 94 cases were located in bilateral ventricles. Sixty-one cases were characterized by single cyst, and 74 cases were multiple or beaded cysts. Three pregnant women had hypertensive disorders in pregnancy. Nineteen cases were found with other fetal abnormalities. One hundred and two cases were followed up successfully, in which 4 cases had induced abortion due to severe deformity,3 cases delivered prematurely（ 1 case died after birth and 2 cases were healthy when followed up ）, 2 fetuses were intrauterine death, 1 case who had ventricular expansion was followed up to 2 years old and developmental delay was found. The rest of 92 cases were followed up for at least 24 months after birth and all of them had a healthy neurological development. Conclusion Prenatal ultrasonography can accurately diagnose fetal subependymal cysts. Excluding other related abnormalities and malformations, isolated subeDendvmal cysts have a good short-term Droznosis.