产前超声诊断Galen静脉瘤的临床价值

Prenatal ultrasonic diagnosis of vein of Galen malformation

目的探讨Galen静脉瘤及合并症的产前超声图像特征,提高其检出率。方法回顾性分析5例经CT和MRI或引产尸检证实的Galen静脉瘤的产前超声表现,总结其图像特点。结果 5例均证实为Galen静脉瘤,其中2例合并右心扩大,三尖瓣返流,上腔静脉扩张;1例合并永存共同动脉干,羊水偏多;1例合并上腔静脉扩张,胎儿水肿,胸腹腔少中量积液,羊水过多;1例合并上腔静脉扩张,胸腹腔少量积液。结论产前超声诊断Galen静脉瘤及合并症有重要的临床价值,尤其在检出胎儿无明显原因心胸比增大、右心扩大及上腔静脉扩张时应仔细观察胎儿颅内情况,丘脑平面、近中线区、第三脑室后方及丘脑后下方检出无回声囊性结构,内可及高速低阻彩色血流是其重要声像图表现。

[Objective] To investigate the characteristics of prenatal ultrasound images of vein of Galen malformation and its complications, and improve the detection rate. [Methods] The ultrasonographic features of 5 cases of vein of Galen malformation confirmed by CT/MRI or autopsy were retrospectively analyzed and summarized. [Results] Five cases were confirmed as vein of Galen malformation, including 2 cases with right ventricular enlargement, tricuspid regurgitation, superior vena cava dilatation. One case was complicated with persistent truncus arteriosus （PTA） and hydramnion. One case was complicated with superior vena cava dilatation, fetal edema, a small amount of pleural effusion and hydramnion. One case was combined with superior vena cava dilatation and a small amount of pleural effusion. [Conclusion] The prenatal ultrasound diagnosis of vein of Galen malformation and complications has important clinical value, particularly the fetal brain should be carefully observed when no obvious reason for cardiothoracic ratio increase, right ventricle enlargement, superior vena cava dilatation. One of the most important ultrasonographic features is no echo cystic structure with high speed and low resistance color flow of thalamus plane, near midline, posterior third ventricle, below and posterior to thalamus were detected.