Novakov-Mikić Aleksandra, Koprivsek Katarina, Lucić Milos, Belopavlović Zoran, Stojić Sinisa, Sekulić Slobodan
Klinika za ginekologiju i akuserstvo, Klinicki centar Vojvodine, Novi Sad.
Med Pregl. 2009 Mar-Apr;62(3-4):157-63. doi: 10.2298/mpns0904157n.
Ultrasonography of the central nervous system is an integral part of a prenatal scan, and the development of imaging technologies has led to better diagnostic possibilities. Posterior fossa anomalies have traditionally been divided into Dandy Walke malformation, Dandy Walker variation and megacisterna magna, but this approach, due to diversity of the extensive number of possible disorders covered by this classification, unables accurate prognosis and therefore adequate counselling. An alternative approach to the classification of posterior fossa anomalies is to divide them into agenesis of the vermis, which could be partial or complete, cerebellar hypoplasia, pontocerebellar hypoplasia and cerebellar atrophy. Different ultrasonographic and magnetic resonance imagining of appearances of the posterior fossa anomalies in prenatal period are discussed in the article, as well as possible syndromes and prognosis of different entities. Diversity of anomalies of the central nervous system, and in particular, subtle differences in prenatal appearances of posterior fossa anomalies, which may have major impact on the prognosis, demand a multidisciplinary approach that encompasses two-dimensional and three-dimensional ultrasound scan, magnetic resonance imaging, infectious diseases and metabolic disorders work-ups as well as individual approach to every case involving of a team of experts in the field of perinatology, radiology, paediatrics, neurology and genetics.
中枢神经系统超声检查是产前扫描不可或缺的一部分，成像技术的发展带来了更好的诊断可能性。传统上，后颅窝异常被分为Dandy-Walker畸形、Dandy-Walker变异型和巨大枕大池，但由于这种分类涵盖的可能疾病种类繁多，这种方法无法进行准确的预后评估，因此也无法提供充分的咨询。后颅窝异常分类的另一种方法是将其分为蚓部发育不全（可部分或完全缺失）、小脑发育不全、脑桥小脑发育不全和小脑萎缩。本文讨论了产前时期后颅窝异常不同的超声和磁共振成像表现，以及不同类型的可能综合征和预后。中枢神经系统异常的多样性，尤其是后颅窝异常产前表现的细微差异，可能对预后产生重大影响，这需要一种多学科方法，包括二维和三维超声扫描、磁共振成像、传染病和代谢紊乱检查，以及针对每一个病例的个体化方法，涉及围产医学、放射学、儿科学、神经学和遗传学领域的专家团队。
