经丘脑水平横切面超声分析孕22~26周胎儿外侧裂异常特征

Characteristics of Fetal Abnormal Sylvian Fissure via Prenatal Ultrasound of Transthalamic Section at 22-26 Weeks of Gestation

目的 探讨孕22~26周胎儿经丘脑水平横切面外侧裂异常的超声声像图特点及临床意义。资料与方法 回顾性分析2018年12月—2022年3月安徽医科大学第二附属医院12例孕22~26周胎儿外侧裂异常病例经丘脑水平横切面超声图像特点、合并颅内外畸形情况及临床结局。结果 根据外侧裂异常声像图特点分为直线形4例和浅弧形8例。直线形外侧裂区域平坦或稍毛糙,其中脑皮层发育畸形1例。浅弧形外侧裂呈切迹或角状,脑岛平台不明显,均为脑皮层发育畸形。合并其他颅脑异常超声征象主要包括其他脑沟回形态异常9例、脑室扩张或脑积水7例、胼胝体部分或完全缺失7例等。11例孕妇选择终止妊娠,1例超声检查5 d后胎死宫内。结论 孕22~26周胎儿外侧裂异常是颅脑神经系统异常特别是脑皮层发育畸形的重要线索。

Purpose To explore the ultrasound imaging characteristics and clinical significance of abnormal sylvian fissure in fetuses of transthalamic section at 22-26 weeks of gestation. Materials and Methods The ultrasound image characteristics, intracranial and extracranial malformations and clinical outcomes of 12 abnormal sylvian fissure cases of transthalamic section at 22-26 weeks of gestation in the Second Affiliated Hospital of Anhui Medical University from December 2018 to March 2022 were retrospectively analyzed. Results According to the ultrasound image characteristics of abnormal sylvian fissure, it could be divided into straight(4 cases) and shallow shapes(8cases). The sylvian fissure of straight shapes was flat. Straight shapes were with 1 malformation of cortical development. The sylvian fissure of shallow shapes was corniform with unconspicuous insular platform. All of the shallow shapes were malformation of cortical development.Common intracranial abnormal signs mainly included other abnormal cerebral gyrus and sulcus(9 cases), ventricular dilatation or hydrocephalus(7 cases), partial or complete agenesis of corpus callosum(7 cases), etc. 11 pregnant women chose to terminate their pregnancy,and 1 fetus died in the uterus after 5 days of ultrasound examination. Conclusion Fetal abnormal sylvian fissure at 22-26 weeks of gestation is an important clue to craniocerebral malformations, especially to malformation of cortical development.