Fesslova Vlasta, Colli Anna Maria, Boito Simona, Fabietti Isabella, Triulzi Fabio, Persico Nicola
Center of Fetal Cardiology, IRCCS Policlinico San Donato, 20097 Milan, Italy.
U.O. Cardiologia, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, 20121 Milan, Italy.
Diagnostics (Basel). 2021 Sep 9;11(9):1651. doi: 10.3390/diagnostics11091651.
Sonographic findings of cerebral arteriovenous malformations in the fetus are uncommon and usually regard aneurysm of the Galen vein. Outcome of arteriovenous malformations is usually severe. We report a case of a fetus at 21 weeks' gestation with a rarer arteriovenous malformation, referred to us for echocardiography on account of a suspicious cardiomegaly at obstetrical scan. Upon examination, we found cardiomegaly, together with an associated moderate tricuspid regurgitation, however, there were no clear features of tricuspid dysplasia. Considering an unusually dilated superior vena cava, we found via color Doppler imaging a systodiastolic flow at Color Doppler progressing. Subsequent MRI of the central nervous system determined the localization in the sinus dura mater. Due to an already evident hemodynamic impact, the parents opted for the termination of the pregnancy. Autopsy confirmed a voluminous arteriovenous malformation of the transverse sinus of the dura mater, severe cardiomegaly, mainly of the ventricles, and hypoplasia of the lungs.
胎儿脑动静脉畸形的超声检查结果并不常见，通常与大脑大静脉瘤有关。动静脉畸形的预后通常很严重。我们报告一例妊娠21周的胎儿，患有一种较为罕见的动静脉畸形，因产科扫描发现可疑心脏增大而转诊至我们处进行超声心动图检查。经检查，我们发现心脏增大，并伴有中度三尖瓣反流，但没有明显的三尖瓣发育异常特征。考虑到上腔静脉异常扩张，我们通过彩色多普勒成像发现彩色多普勒有收缩期和舒张期血流。随后的中枢神经系统MRI确定病变位于硬脑膜窦。由于已经出现明显的血流动力学影响，父母选择终止妊娠。尸检证实硬脑膜横窦有大量动静脉畸形、严重心脏增大，主要是心室增大，以及肺发育不全。
