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胎儿大脑:迁移和回旋异常——产前与产后的相关性

The fetal brain: migration and gyration anomalies - pre- and postnatal correlations.

作者信息

Papaioannou Georgia, Garel Catherine

机构信息

Department of Pediatric Radiology, Mitera Maternity and Children's Hospital, 6 Erythrou Stavrou str, 15123, Maroussi, Athens, Greece.

Service de Radiologie, Hôpital d'Enfants Armand-Trousseau APHP, Sorbonne Université, Paris, France.

出版信息

Pediatr Radiol. 2023 Apr;53(4):589-601. doi: 10.1007/s00247-022-05458-9. Epub 2022 Aug 1.

Abstract

The cerebral cortex represents a laminar structure of precisely spatially organized neurons in horizontal layers and vertical columns. Neurogenesis, neuronal migration and neuronal wiring are tightly regulated and coordinated procedures that result in the accurate formation of the human cerebral cortex. Abnormal fetal corticogenesis results in several types of migration and gyration anomalies, known as malformations of cortical development, which have long been a topic of investigation. According to the stage of cortical development that is affected, with diverse genetic and non-genetic etiologies, these malformations can cause abnormal head size, abnormal brain surface and abnormal cortical layering with various degrees of neurodevelopmental delay and epilepsy. The pathogenesis of these malformations is multifactorial and includes genetic mutations or environmental insults, acquired either in utero at varying stages of brain development or during the perinatal period after corticogenesis. In this article, we focus on cortical malformations detected on fetal MRI. We present the main antenatal findings that should raise suspicion for malformations of cortical development, together with findings that might be missed on prenatal imaging and describe the correlations between fetal and postnatal MRI.

摘要

大脑皮层是一种呈层状结构的组织,由水平层和垂直柱中精确空间排列的神经元组成。神经发生、神经元迁移和神经元布线是严格调控和协调的过程,这些过程导致人类大脑皮层的精确形成。胎儿皮质发生异常会导致几种类型的迁移和回旋异常,即所谓的皮质发育畸形,长期以来一直是研究的课题。根据受影响的皮质发育阶段,由于遗传和非遗传病因各异,这些畸形可导致头部大小异常、脑表面异常和皮质分层异常,并伴有不同程度的神经发育迟缓及癫痫。这些畸形的发病机制是多因素的,包括基因突变或环境损害,这些损害可在大脑发育的不同阶段于子宫内获得,或在皮质发生后的围产期获得。在本文中,我们重点关注胎儿磁共振成像(MRI)检测到的皮质畸形。我们介绍了应引起对皮质发育畸形怀疑的主要产前检查结果,以及产前成像可能遗漏的结果,并描述了胎儿和产后MRI之间的相关性。

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