Bernard C, Droulle P, Didier F, Gérard H, Larroche J C, Plenat F, Bomsel F, Roland J, Hoeffel J C
Service de Radiologie, Hôpital d'Enfants, Vandoeuvre.
J Radiol. 1988 Aug-Sep;69(8-9):521-32.
70 fetuses (10 to 37 weeks) and 30 full term infants were examined by ultrasound (U.S.). Anatomic correlations were made with frontal, axial and sagittal sections of 43 fetal and 3 neonatal brains. At 12 weeks gestational age (w.g.a.) only the inter hemispheric fissure is seen by U.S. The sylvian fissure (21 w.g.a.), the callosal sulcus (21 w.g.a.), the parieto-occipital sulcus (25 w.g.a.), the calcarine fissure (25 w.g.a.), the cingulate sulcus (26 w.g.a.) and the collateral sulcus (25-27 w.g.a.) are visualized rather late with in-utero U.S. The other sulci are more difficult to see. The peripheral location of these sulci contributes to the difficulty encountered in their visualization. The morphology of the sylvian fissure is quite characteristic on U.S. imaging and can be used to estimate the gestational age of the fetus. Compared to the embryological development there is a 2-4 weeks delay between the first infolding of the brain and the visualization of a sulcus by U.S. Abnormal sulcal patterns can be recognized based on the normal appearance for each gestational age. Sulcal anomalies are quite specific in holoprosencephaly, lissencephaly, micropolygyry, schizencephaly, agenesis of the corpus callosum. Silhouetting of the sulci may occur if the parenchymal echogenicity is sufficiently increased that the sulci no longer stand out (ischemia, tumors, encephalitis). Thickening of the sulci occurs in subdural hematomas, external hydrocephalus, meningitis and toxoplasmosis.
对70例胎儿(孕龄10至37周)和30例足月儿进行了超声检查。将超声图像与43例胎儿及3例新生儿脑的额状面、轴位和矢状面进行了解剖学对照。孕12周时,超声仅能显示大脑半球间裂。大脑外侧裂(孕21周)、胼胝体沟(孕21周)、顶枕沟(孕25周)、距状沟(孕25周)、扣带沟(孕26周)和侧副沟(孕25 - 27周)在宫内超声检查中显示较晚。其他脑沟则更难显示。这些脑沟的周边位置导致了其显示的困难。大脑外侧裂的形态在超声成像上具有相当的特征性,可用于估计胎儿的孕龄。与胚胎发育相比,脑沟首次内陷与超声显示之间有2 - 4周的延迟。基于各孕龄的正常表现可识别异常脑沟模式。脑沟异常在全前脑畸形、无脑回畸形、微小多脑回畸形、脑裂畸形、胼胝体发育不全中具有相当的特异性。如果脑实质回声足够增强,脑沟不再突出(如缺血、肿瘤、脑炎),则脑沟可能会出现轮廓消失。脑沟增宽见于硬膜下血肿、外部性脑积水、脑膜炎和弓形虫病。