Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
J Ultrasound Med. 2009 Dec;28(12):1629-37. doi: 10.7863/jum.2009.28.12.1629.
The purpose of this study was to evaluate the importance of echogenic material in the fetal frontal horns.
This was a Health Insurance Portability and Accountability Act-compliant, Institutional Review Board-approved retrospective study. In part 1 of the study, prenatal sonography, prenatal magnetic resonance imaging (MRI), and birth outcomes of 17 fetuses (mean gestational age, 19 weeks; range, 15-34 weeks) with prospective echogenic material in the frontal horns were assessed. In part 2, 400 consecutive sonographic fetal surveys (mean gestational age, 19 weeks; range, 15-38 weeks) were reviewed to determine the incidence. In part 3, 2 independent reviewers assessed the appearance of the frontal horns in 40 fetuses (20 with suspected intraventricular hemorrhage from parts 1 and 2 and 20 who were interpreted to have normal findings in part 2).
Part 1 of the study showed that suspected hemorrhage was unilateral in 13 fetuses and bilateral in 4. Additional findings by sonography were grade 4 intraventricular hemorrhage (n = 2), ventriculomegaly (n = 2), and porencephaly (n = 1). An additional finding by MRI was porencephaly in 1 fetus. In part 2, echogenic material in the frontal horns was identified in 3 of 400 fetuses (0.8%). In part 3, hemorrhage was probably or definitely present in 11 of the 20 fetuses with abnormalities; material looked like a cyst in 6; and normal choroid was in an abnormal position in 2 and a normal position 1. Of 19 fetuses with abnormalities, 14 had a posteriorly symmetric choroid; 9 had material of different echogenicity compared with the choroid; and 17 had an expanded frontal horn. Birth outcomes were abnormal in 7, including platelet abnormalities (n = 2), hemorrhage on imaging or pathologic examination (n = 2), extraventricular hemorrhage (n = 3), and ventriculomegaly (n = 3).
The incidence of echogenic material in the frontal horns is less than 1%. This does not represent the normal location of the choroid plexus and may represent hemorrhage, which may resolve without sequelae or result in ventriculomegaly and porencephaly.
本研究旨在评估胎儿额叶内强回声物质的重要性。
本研究符合《健康保险携带和责任法案》和机构审查委员会的规定，为回顾性研究。在研究的第 1 部分，评估了 17 例（平均孕龄 19 周；范围 15-34 周）胎儿额叶内有前瞻性强回声物质的产前超声、产前磁共振成像（MRI）和出生结局。在第 2 部分，回顾了 400 例连续的胎儿超声检查（平均孕龄 19 周；范围 15-38 周），以确定发生率。在第 3 部分，2 名独立评估者评估了 40 例胎儿的额叶外观（20 例来自第 1 部分和第 2 部分的疑似脑室出血，20 例来自第 2 部分的正常发现）。
研究的第 1 部分显示，13 例胎儿的疑似出血为单侧，4 例为双侧。超声检查的其他发现为 4 级脑室出血（n=2）、脑室扩大（n=2）和脑裂畸形（n=1）。MRI 的其他发现为 1 例脑裂畸形。在第 2 部分，400 例胎儿中发现 3 例额叶内有强回声物质（0.8%）。在第 3 部分，20 例异常胎儿中，11 例可能或明确存在出血；6 例呈囊肿样；2 例脉络膜位置异常，1 例位置正常。在 19 例异常胎儿中，14 例后部对称脉络膜；9 例与脉络膜相比回声不同；17 例额叶扩大。7 例患儿的出生结局异常，包括血小板异常（n=2）、影像学或病理学检查有出血（n=2）、脑室出血（n=3）和脑室扩大（n=3）。
额叶内强回声物质的发生率小于 1%。这并不代表脉络膜的正常位置，可能代表出血，出血可能自行消退而无后遗症，也可能导致脑室扩大和脑裂畸形。
