Guibaud L, Selleret L, Larroche J C, Buenerd A, Alias F, Gaucherand P, Des Portes V, Pracros J-P
Imagerie Pédiatrique et Foetale, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon I, Lyon-Bron, France.
Ultrasound Obstet Gynecol. 2008 Jul;32(1):50-60. doi: 10.1002/uog.5357.
To illustrate and determine the significance of abnormal Sylvian fissure development (or abnormal operculization) in cases in which prenatal cerebral imaging is suggestive of underlying cortical dysplasia.
This was a retrospective study of 15 fetuses at 24-34 weeks in which abnormal operculization was identified on prenatal cerebral imaging and for which follow-up data were available. The imaging findings were correlated to macro- and microscopic neuropathological data (n = 11) or to postnatal clinical and imaging findings (n = 4).
On microscopic examination of fetuses from 11 terminated pregnancies, abnormal operculization was associated with cortical dysplasia in four cases and the cortex was normal in seven. Abnormal operculization was associated with cortical dysplasia in only one of the four liveborn infants. Cases of abnormal Sylvian fissure development with normal cortical architecture were classified, according to associated anomalies of the central nervous system, into one of five groups: those with neural tube defects, microcephaly or frontal hypoplasia, glutaric aciduria, other cerebral abnormalities, and extracerebral anomalies.
Abnormal operculization on prenatal imaging does not systematically reflect underlying cortical dysplasia. It may be related to extracortical factors such as abnormal cerebral volume or other developmental anomalies of the central nervous system. An understanding of the significance of abnormal Sylvian fissure development could be useful in integrating its analysis into a more general one of the whole central nervous system.
阐述并确定产前脑成像提示潜在皮质发育异常病例中大脑外侧裂发育异常（或脑盖形成异常）的意义。
这是一项对15例孕24 - 34周胎儿的回顾性研究，这些胎儿在产前脑成像中被发现存在脑盖形成异常且有随访数据。将成像结果与大体和微观神经病理学数据（n = 11）或产后临床及成像结果（n = 4）进行关联。
在对11例终止妊娠胎儿的显微镜检查中，4例脑盖形成异常与皮质发育异常相关，7例皮质正常。在4例活产婴儿中，只有1例脑盖形成异常与皮质发育异常相关。大脑外侧裂发育异常但皮质结构正常的病例，根据中枢神经系统相关异常情况，被分为五组之一：神经管缺陷、小头畸形或额叶发育不全、戊二酸尿症、其他脑异常以及脑外异常。
产前成像中的脑盖形成异常并非总是反映潜在的皮质发育异常。它可能与脑外因素有关，如脑容量异常或中枢神经系统的其他发育异常。了解大脑外侧裂发育异常的意义有助于将其分析纳入对整个中枢神经系统更全面的分析中。
