Malinger G, Lev D, Ben Sira L, Kidron D, Tamarkin M, Lerman-Sagie T
Prenatal Diagnosis Unit, Department of Obstetrics and Gynecology, Institute of Medical Genetics, and Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
Ultrasound Obstet Gynecol. 2002 Nov;20(5):447-51. doi: 10.1046/j.1469-0705.2002.00840.x.
Periventricular pseudocysts (PVPC) are diagnosed in approximately 1% of premature newborns that undergo brain sonography during the first 24 h of life. These pseudocysts are thought to develop antenatally due to germinal matrix hemorrhage, but have not been described until now in prenatal ultrasound studies. The aim of this study was to report the identification, differential diagnosis, and prognosis of PVPC detected by prenatal ultrasound examination.
Between 1997 and 2001 we made an ultrasound diagnosis of PVPC in 11 fetuses. In nine fetuses the findings were characteristic of PVPC and these patients represent our study group. Fetal magnetic resonance imaging was performed in five patients. Termination of pregnancy was carried out in three patients, in one case intrauterine fetal death occurred at 31 weeks, and one infant died in the neonatal period. The surviving four newborns are being followed in the pediatric neurology clinic.
PVPC were diagnosed by ultrasound scan in fetuses between 16 and 37 weeks of gestation (mean, 29.7 weeks). Magnetic resonance imaging confirmed the presence of PVPC in two cases. In eight cases the pseudocysts were unilateral and in one case bilateral. They were an isolated finding in five patients. Four of these fetuses were delivered at term and have normal neurological development at ages ranging from 6 to 25 months. All fetuses with additional pathologies (coarctation of the aorta, hemimegalencephaly, cytomegalovirus infection, hypoplasia of the vermis with dysmorphism) did not survive.
The prenatal diagnosis of PVPC warrants an extensive search for possible associated pathological findings. As an isolated finding, antenatal PVPC seem to carry a good prognosis.
在出生后24小时内接受脑部超声检查的早产儿中，脑室周围假性囊肿（PVPC）的诊断率约为1%。这些假性囊肿被认为是由于生发基质出血在产前形成的，但在目前的产前超声研究中尚未见报道。本研究的目的是报告产前超声检查发现的PVPC的识别、鉴别诊断及预后情况。
1997年至2001年间，我们对11例胎儿进行了PVPC的超声诊断。其中9例胎儿的检查结果具有PVPC的特征，这些患者构成了我们的研究组。对5例患者进行了胎儿磁共振成像检查。3例患者终止妊娠，1例在31周时发生宫内胎儿死亡，1例婴儿在新生儿期死亡。其余4名存活新生儿在儿科神经科门诊接受随访。
超声扫描在妊娠16至37周（平均29.7周）的胎儿中诊断出PVPC。磁共振成像在2例中证实了PVPC的存在。8例假性囊肿为单侧，1例为双侧。在5例患者中，PVPC是唯一的发现。其中4例足月分娩的胎儿在6至25个月龄时神经发育正常。所有合并其他病变（主动脉缩窄、半侧巨脑畸形、巨细胞病毒感染、小脑蚓部发育不全伴畸形）的胎儿均未存活。
PVPC的产前诊断需要广泛寻找可能相关的病理发现。作为唯一的发现，产前PVPC似乎预后良好。
