Abergel Adva, Lacalm Audrey, Massoud Mona, Massardier Jérôme, des Portes Vincent, Guibaud Laurent
Département d'Imagerie Pédiatrique et Fœtale, Hôpital Femme Mère Enfant, Lyon-Bron, France.
Fetal Diagn Ther. 2017;41(3):226-233. doi: 10.1159/000447740. Epub 2016 Jul 14.
The aim of this study was to report the prenatal imaging findings of expanding porencephalic cyst, which have not been previously described in the prenatal period, and to underline that these lesions can involve the cerebellum and not exclusively the supratentorial structures.
This is a retrospective observational study of five cases with a prenatal diagnosis of expanding porencephalic cyst.
The cystic lesion was located in the supra- and infratentorial space in 2 cases, respectively, or in both in one case. The lesion expanded into the pericerebral space or communicated with the ventricular system in 4 and 1 cases, respectively. Differential diagnosis included tumoural lesion in 2 cases because of internal echogenic components related to haemorrhagic changes, which were identified using foetal MRI, and arachnoid cyst in 2 cases because of expansion into the pericerebral space. In the last case, communication within the ventricular system mimicked a unilateral ventriculomegaly.
Differential diagnosis of any cystic lesion with extra-axial component should include expanding porencephalic cyst. Foetal MRI is helpful to differentiate this entity from extra-axial lesions such as arachnoid cysts but also from rare tumours.
本研究旨在报告产前影像学上脑穿通性囊肿扩大的表现,此前尚无产前相关描述,并强调这些病变可累及小脑,而非仅累及幕上结构。
这是一项对5例产前诊断为脑穿通性囊肿扩大病例的回顾性观察研究。
囊性病变分别位于幕上和幕下间隙各2例,1例同时累及幕上和幕下。病变分别有4例扩展至脑周间隙或1例与脑室系统相通。鉴别诊断方面,2例因内部存在与出血性改变相关的回声成分(通过胎儿MRI识别)而考虑肿瘤性病变,2例因扩展至脑周间隙而考虑蛛网膜囊肿。最后1例中,脑室系统内的连通类似单侧脑室扩大。
对任何具有轴外成分的囊性病变进行鉴别诊断时应考虑脑穿通性囊肿扩大。胎儿MRI有助于将该病变与轴外病变如蛛网膜囊肿以及罕见肿瘤相鉴别。