对270例宫内磁共振成像未见透明隔腔和穹窿腔的胎儿进行分析。

Griffiths P D, Jarvis D

Academic Unit of Radiology, University of Sheffield, Sheffield, UK.

Ultrasound Obstet Gynecol. 2020 Nov;56(5):732-739. doi: 10.1002/uog.21919.

OBJECTIVE

To analyze a large retrospective cohort of fetuses in which the cavum septi pellucidi and vergae (CSPV) was not present or was not in its expected position on in-utero magnetic resonance imaging (iuMRI), in order to describe the possible causes of that finding and provide a diagnostic approach to assess such cases in clinical practice using iuMRI.

METHODS

This was a retrospective study of fetuses that underwent iuMRI at a single institution, over an 18-year period (2000-2017 inclusive), in which the CSPV was not visualized or was abnormal. All iuMRI studies were reviewed and classified as CSPV being not present, disrupted (visualization of remnants of an otherwise normally placed CSPV) or malpositioned (CSPV was present, but not in its expected position). We describe the neuropathology present in each of the groups.

RESULTS

Of the 270 fetuses that met the inclusion criteria, the CSPV was described as malpositioned in 150 (56%), disrupted in 71 (26%) and not present in 49 (18%). Malpositioned CSPV was present only in cases with agenesis of the corpus callosum and three specific patterns of malpositioning are described, depending on the location of the leaflets of the CSPV and fornix. Disrupted CSPV was present in fetuses with hydrocephalus or pathologies causing extensive brain parenchymal injury. Not present CSPV was found in cases with holoprosencephaly or when absence of the CSPV appeared to be an isolated finding.

CONCLUSION

We have described a large cohort of fetuses with non-visualization of a normal CSPV on iuMRI and present a categorical classification system based on the CSPV being not present, disrupted or malpositioned. This approach should help in the diagnosis of the underlying cause of a CSPV abnormality. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

目的

分析一大组胎儿的回顾性队列，这些胎儿在宫内磁共振成像（iuMRI）中透明隔腔和Vergae腔（CSPV）不存在或不在预期位置，以描述该发现的可能原因，并提供一种诊断方法，用于在临床实践中使用iuMRI评估此类病例。

方法

这是一项对在单一机构接受了18年（2000年至2017年，含2000年和2017年）iuMRI检查的胎儿进行的回顾性研究，这些胎儿的CSPV未显示或异常。对所有iuMRI研究进行了回顾，并分类为CSPV不存在、中断（原本正常位置的CSPV残余可视化）或位置异常（CSPV存在，但不在预期位置）。我们描述了每组中存在的神经病理学情况。

结果

在符合纳入标准的270例胎儿中，CSPV被描述为位置异常的有150例（56%），中断的有71例（26%），不存在的有49例（18%）。位置异常的CSPV仅出现在胼胝体发育不全的病例中，并根据CSPV小叶和穹窿的位置描述了三种特定的位置异常模式。中断的CSPV出现在脑积水或导致广泛脑实质损伤的病变的胎儿中。未发现CSPV出现在全前脑病例中，或当CSPV缺失似乎是一个孤立发现时。