Senat M V, Bernard J P, Schwärzler P, Britten J, Ville Y
Fetal Medicine Unit, St. George's Hospital Medical School, London, UK.
Ultrasound Obstet Gynecol. 1999 Nov;14(5):327-32. doi: 10.1046/j.1469-0705.1999.14050327.x.
To report prospectively the prenatal diagnosis, management and outcome of 14 cases of unilateral ventriculomegaly.
Fourteen fetuses were diagnosed as having one ventricle of > or = 10 mm, as measured at the level of the atrium.
In ten cases, the scan showed mild unilateral ventriculomegaly with an atrium width between 11 and 13 mm and this remained stable up to term. Eight of these fetuses had a magnetic resonance imaging scan in utero between 32 and 34 weeks of gestation which confirmed the diagnosis of mild ventriculomegaly without other brain abnormalities and showed a normal cortical mantle. No obvious cause was found and the outcome was normal in all cases. In four cases, the unilateral ventriculomegaly evolved rapidly with an atrium width up to 20-25 mm. Causes included atresia of the foramen of Monro, toxoplasmosis, brain atrophy and Weaver syndrome. Three underwent termination of pregnancy and the postmortem examination confirmed the diagnosis. The baby with brain atrophy and schizencephaly had a ventriculoperitoneal shunt placed at 1 month of age and has severe developmental delay at 9 months.
The prognosis of unilateral ventriculomegaly is uncertain. Examination of both ventricles during the anomaly scan should be performed, as should ultrasound follow-up of these cases up to the end of the third trimester. Fetuses with an isolated, mild, stable unilateral ventriculomegaly seem to have a favourable neurological outcome. However, fetuses with rapidly evolving unilateral ventriculomegaly or cases associated with other brain abnormalities may have a poor neurological outcome.
前瞻性报告14例单侧脑室扩大的产前诊断、处理及结局。
14例胎儿经诊断在心房水平测得一侧脑室≥10 mm。
10例扫描显示轻度单侧脑室扩大，心房宽度在11至13 mm之间，直至足月保持稳定。其中8例胎儿在妊娠32至34周时接受了宫内磁共振成像扫描，证实为轻度脑室扩大，无其他脑部异常，皮质板正常。未发现明显病因，所有病例结局正常。4例单侧脑室扩大迅速发展，心房宽度达20 - 25 mm。病因包括室间孔闭锁、弓形虫病、脑萎缩和韦弗综合征。3例终止妊娠，尸检证实诊断。患有脑萎缩和脑裂畸形的婴儿在1月龄时进行了脑室腹腔分流术，9月龄时存在严重发育迟缓。
单侧脑室扩大的预后不确定。在畸形扫描时应检查双侧脑室，这些病例直至孕晚期也应进行超声随访。孤立、轻度、稳定的单侧脑室扩大胎儿似乎有良好的神经学结局。然而，单侧脑室扩大迅速发展的胎儿或伴有其他脑部异常的病例可能有不良的神经学结局。
