Pashaj S, Merz E
Ultrasound Department, Maternity Hospital Koco Gliozheni, Tirana, Albania.
Center for Ultrasound and Prenatal Medicine, Frankfurt am Main, Germany.
Ultraschall Med. 2016 Apr;37(2):185-94. doi: 10.1055/s-0041-108565. Epub 2015 Nov 3.
The objective of this study was to prenatally detect corpus callosum pathologies such as agenesis, partial agenesis, hypo- and hyperplasia and enhanced echogenicity.
Between 2009 and 2013 detailed 3D ultrasound examinations of the fetal corpus callosum were carried out as part of a level III examination for fetal anomalies. All scans were performed using Voluson E8 equipment (GE, Zipf, Austria) with a 5 - 8 MHz 3D transabdominal and 5 - 9 MHz 3D transvaginal transducer. All cases were evaluated for the following variables: inner, outer and curved length of the corpus callosum, height of the different segments of the corpus callosum and the corpus callosum area. All parameters were compared with normal growth charts. In all cases of suspected corpus callosum anomaly direct and indirect signs for corpus callosum agenesis and associated malformations were observed.
31 fetuses with pathological corpus callosum were diagnosed with 3D ultrasound. Gestational age at the time of diagnosis ranged from 20 to 38 weeks. 12 cases showed agenesis, 11 cases partial agenesis, 5 cases hypoplasia, 2 cases a combination of partial hyper- and hypoplasia and one case a lipoma of the corpus callosum. In corpus callosum underdevelopment, the more affected parts were the body and splenium. Associated anomalies were present in 25 of the 31 cases (80.6%) of corpus callosum pathologies.
3D neurosonography serves as an excellent tool to precisely demonstrate the pathological development of the fetal corpus callosum. By correlating the measures with the function of each affected corpus callosum segment, we can try to get a vague prediction of the neurological prognosis.
本研究的目的是产前检测胼胝体病变,如发育不全、部分发育不全、发育不良和增生以及回声增强。
2009年至2013年间,作为胎儿畸形三级检查的一部分,对胎儿胼胝体进行了详细的三维超声检查。所有扫描均使用Voluson E8设备(通用电气,齐普夫,奥地利),配备5-8MHz的三维经腹探头和5-9MHz的三维经阴道探头。对所有病例评估以下变量:胼胝体的内、外和弯曲长度、胼胝体不同节段的高度以及胼胝体面积。所有参数均与正常生长图表进行比较。在所有疑似胼胝体异常的病例中,观察到胼胝体发育不全和相关畸形的直接和间接征象。
31例胼胝体病变胎儿经三维超声诊断。诊断时的孕周为20至38周。12例表现为发育不全,11例为部分发育不全,5例为发育不良,2例为部分增生和发育不良合并,1例为胼胝体脂肪瘤。在胼胝体发育不全中,受影响较严重的部位是体部和压部。31例胼胝体病变病例中有25例(80.6%)存在相关异常。
三维神经超声是精确显示胎儿胼胝体病理发育的优秀工具。通过将测量结果与每个受影响的胼胝体节段的功能相关联,我们可以尝试对神经预后进行模糊预测。