Bowerman R A, DiPietro M A
AJNR Am J Neuroradiol. 1987 Jul-Aug;8(4):661-4.
We show, through correlation of fetal, neonatal, and necropsy brain sonography, that the three-parallel-echogenic-line configuration classically thought to represent fetal lateral ventricular margins on high axial images are actually extraventricular, lying within cerebral white matter. Accurate sonographic identification of fetal hydrocephalus is essential for appropriate patient management. Both qualitative and quantitative methods of determining ventriculomegaly have been described. The latter require identification of lateral ventricular walls for subsequent ventricular mensuration and comparison with hemispheric width. The parallel-line configuration, thought to represent ventricular margins, has been used for such measurements. We have--through careful fetal, neonatal, and necropsy specimen scanning in several planes--determined that the presumed ventricular wall echoes are actually extraventricular, arising from fibers within the cerebral white matter aligned perpendicular to the sonographic beam. This is identical to the etiology of the normal echogenic periventricular "blush" described in the neonate. Since these parallel echogenic lines do not represent actual ventricular margins, they should not be relied upon for the diagnosis of ventriculomegaly.
通过对胎儿、新生儿及尸检脑部超声检查结果的相关性分析，我们发现，在高轴位图像上传统上被认为代表胎儿侧脑室边缘的三条平行强回声线实际上位于脑室之外，处于脑白质内。准确的超声诊断胎儿脑积水对于恰当的患者管理至关重要。确定脑室扩大的定性和定量方法均已被描述。后者需要识别侧脑室壁以便随后进行脑室测量并与半球宽度作比较。被认为代表脑室边缘的平行线结构已被用于此类测量。通过在多个平面仔细扫描胎儿、新生儿及尸检标本，我们确定，假定的脑室壁回声实际上位于脑室之外，由垂直于超声束排列的脑白质内纤维产生。这与新生儿中描述的正常脑室周围强回声“红晕”的病因相同。由于这些平行强回声线并不代表实际的脑室边缘，因此不应依赖它们来诊断脑室扩大。
