Rummeny C, Ertl-Wagner B, Reiser M F
Institut für Klinische Radiologie, Klinikum der Universität München, Grosshadern, München.
Radiologe. 2003 Nov;43(11):925-33. doi: 10.1007/s00117-003-0975-7.
The corpus callosum is formed between the 7th and the 20th gestational week. If this process is disrupted, partial or complete callosal agenesis may ensue. As large parts of the supra- and infratentorial brain are created during this critical period, associated anomalies need always to be searched for when callosal agenesis is present. Associations with neuro-genetic syndromes also exist. The corpus callosum is generally formed from front to back ("front-to-back rule"). Therefore, a partial callosal agenesis usually involves the posterior portion of the corpus callosum, while a secondary lesion of the corpus callosum does not follow this rule. Holoprosencephalies are a notable exception to this rule, as the frontal part of the corpus callosum is absent in spite of their classification as congenital malformations. They represent a disturbance of the differentiation and cleavage of the prosencephalon with a disruption of the separation of the cerebral hemispheres. Holoprosencephalies can be due to genetic causes, but also to intrauterine infections or other teratogenic causes. The holoprosencephalies are subdivided into alobar, semilobar and lobar holoprosencephalies. This article aims to describe the most important features of callosal agenesis and holoprosencephalies highlighting the respective imaging characteristics.
胼胝体在妊娠第7至20周之间形成。如果这个过程受到干扰,可能会导致部分或完全胼胝体发育不全。由于幕上和幕下脑的大部分在这个关键时期形成,当存在胼胝体发育不全时,总是需要寻找相关的异常情况。也存在与神经遗传综合征的关联。胼胝体通常由前向后形成(“由前向后规则”)。因此,部分胼胝体发育不全通常累及胼胝体的后部,而胼胝体的继发性病变则不遵循此规则。全前脑畸形是此规则的一个显著例外,尽管它们被归类为先天性畸形,但胼胝体的前部却不存在。它们代表了前脑分化和分裂的紊乱以及大脑半球分离的破坏。全前脑畸形可能是由遗传原因引起的,但也可能是由宫内感染或其他致畸原因引起的。全前脑畸形可细分为无脑叶型、半脑叶型和脑叶型全前脑畸形。本文旨在描述胼胝体发育不全和全前脑畸形的最重要特征,突出各自的影像学特征。