Soto Ares G, Deries B, Delmaire C, Devisme L, Ruchoux M M, Pruvo J-P
Département de Neuroradiologie, Hôpital Roger Salengro, Lille.
J Radiol. 2004 Jun;85(6 Pt 1):729-40. doi: 10.1016/s0221-0363(04)97675-5.
Because it is now possible to obtain high-resolution multiplanar MR imaging of the cerebellum and because of the developing interest on the role of the cerebellum on higher brain functions, we have decided to study the process of cerebellar fissuration. All brain MRI examinations performed in children for varied neurological and neurosurgical indications, especially children with non-specific mental retardation and patients with cerebral malformation detected at initial imaging work-up, were reviewed. Fissuration and lobulation anomalies (abnormal orientation of fissures, pseudopolymicrogyria, cortical thickening, subcortical cysts and heterotopia) were identified that we called cerebellar cortical dysplasia (CCD). In order to better understand the origin of this malformation, current data on cerebellar embryogenesis and histogenesis will be reviewed, and the pathological and radiological features will be illustrated. Milder forms of CCD represent a distinct group of anomalies that should be distinguished from other types of cerebellar dysplasia (agenesis, hypoplasia or complex dysplasia with involvement of the cerebellar vermis (rhombencephalosynapsis)) or combined cerebellar and cerebral dysplasia (muscular dystrophies and lissencephaly). Recognition of cerebellar cortical dysplasia could be a first step towards a broader understanding of its pathogenesis and significance.
由于现在能够获得小脑的高分辨率多平面磁共振成像,并且由于对小脑在高级脑功能中的作用的兴趣不断增加,我们决定研究小脑裂形成的过程。回顾了所有因各种神经和神经外科指征而在儿童中进行的脑部磁共振成像检查,特别是那些患有非特异性智力发育迟缓的儿童以及在初次成像检查时发现有脑畸形的患者。发现了裂和小叶异常(裂的异常方向、假性多小脑回、皮质增厚、皮质下囊肿和异位),我们将其称为小脑皮质发育异常(CCD)。为了更好地理解这种畸形的起源,将回顾当前关于小脑胚胎发生和组织发生的数据,并说明其病理和放射学特征。较轻形式的CCD代表一组独特的异常,应与其他类型的小脑发育异常(发育不全、发育不良或伴有小脑蚓部受累的复杂发育异常(菱形脑融合))或小脑和大脑联合发育异常(肌营养不良和无脑回畸形)区分开来。认识小脑皮质发育异常可能是更广泛地理解其发病机制和意义的第一步。