Bronsteen Richard, Lee Wesley, Vettraino Ivana, Balasubramaniam Mamtha, Comstock Christine
Division of Fetal Imaging, William Beaumont Hospital, 3601 W Thirteen Mile Rd, Royal Oak, Michigan 48073, USA.
J Ultrasound Med. 2006 Mar;25(3):343-7. doi: 10.7863/jum.2006.25.3.343.
This study was undertaken to investigate the natural history and clinical importance of choroid plexus separation (a > or = 3 mm distance between the choroid plexus and medial wall of the lateral ventricle) as an isolated finding in the second trimester.
This was a 5-year retrospective review of an ultrasound database, looking for singleton fetuses with a menstrual age of 16 to 26 weeks and a finding of isolated choroid plexus separation.
There were 78 cases available for study. The finding of choroid plexus separation was usually transient. Resolution was noted in 37% of the cases that were rescanned within 2 weeks and 71% of the cases that were rescanned more than 2 weeks after the initial diagnosis. Two abnormal karyotypes (trisomy 21 and 47,XXY) and 3 cases with abnormal development not associated with an abnormal karyotype were noted on neonatal follow-up. Cases with abnormal development were quite varied in their presentation.
The finding of isolated choroid plexus separation is usually temporary, resolving in most cases within 4 weeks of the initial diagnosis. Most infants with this finding have no abnormalities. The clinical implication of the lone case of trisomy 21 was limited by a major preexisting risk in this patient. The 3 cases of abnormal development had varying presentations; the causal nature of this association is not yet clear. No trends were noted between the changing choroid plexus appearance with time and abnormal neonatal outcome, but the number of abnormal cases was quite limited.
本研究旨在调查脉络丛分离(脉络丛与侧脑室内侧壁之间距离≥3mm)作为孕中期孤立发现的自然病史及临床重要性。
这是一项对超声数据库进行的为期5年的回顾性研究,寻找月经龄为16至26周且有孤立脉络丛分离发现的单胎胎儿。
有78例可供研究。脉络丛分离的发现通常是短暂的。在初次诊断后2周内再次扫描的病例中,37%的病例分离情况得到缓解;在初次诊断后2周以上再次扫描的病例中,71%的病例分离情况得到缓解。新生儿随访时发现2例异常核型(21三体和47,XXY)以及3例发育异常但核型正常的病例。发育异常的病例表现各异。
孤立脉络丛分离的发现通常是暂时的,大多数病例在初次诊断后4周内缓解。大多数有此发现的婴儿无异常。该21三体单例患者的临床意义因存在重大的既往风险而受限。3例发育异常病例表现各异;这种关联的因果性质尚不清楚。未发现脉络丛外观随时间变化与新生儿异常结局之间存在趋势,但异常病例数量相当有限。