产前超声诊断胎儿脊膜囊肿伴脊髓栓系一例

Meningeal cysts complicated with tethered cord syndrome diagnosed by prenatal ultrasonography: a case report

本文报道1例孕妇孕37周+5产前超声检查诊断胎儿脊膜囊肿并发脊髓栓系综合征,同时存在马蹄肾以及肝内血管异常交通(动静脉瘘)。孕39周+4急产分娩,生后发现新生儿肛门开口于正常肛门位置前方1 cm。新生儿超声及CT检查提示肝内动静脉瘘形成、马蹄肾;腰骶椎MRI提示椎管内囊性占位性病变。行"椎管探查术+椎管肿瘤切除术",术后病理证实为室管膜囊肿,证实产前超声诊断。术后CT检查显示腰椎术后改变。患儿5月龄时成功实施肛门成形术。随访至患儿1岁8个月,生长发育未见异常。提高对脊髓栓系综合征的认识,有助于减少漏诊及误诊。

We reported a case diagnosed with meningeal cysts complicated with tethered cord syndrome based on prenatal ultrasound images at 37+5 gestational weeks, which also showed horseshoe kidney and intrahepatic vascular abnormalities (arteriovenous fistula) in the fetus. The gravida had a precipitate delivery at 39+4 gestational weeks. The anus of this newborn was about 1 cm in front of the normal position. Intrahepatic arteriovenous fistula and horseshoe kidney were detected by neonatal ultrasound and CT scan, and spinal cystic occupying lesion was found by lumbar-sacrum MRI. Intraspinal tumors were removed through spinal canal exploration and spinal cord tumor resection and were confirmed as ependymal cysts by pathological analysis, which was consistent with the prenatal diagnosis. Postoperative changes of lumbar spine was reported by CT scan after the operation. The baby received successful anoplasty when five months old and no abnormal growth or development were found when followed up to one year and eight months old. Raising awareness of tethered cord syndrome can help reduce missed diagnosis and misdiagnosis.