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[先天性脑畸形]

[Congenital brain malformations].

作者信息

Spieth Stephanie, Hahn Gabriele

机构信息

Institut und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.

Pädiatrische Radiologie, Universitäts-Kinderspital beider Basel, Spitalstraße 33, 4056, Basel, Schweiz.

出版信息

Radiologie (Heidelb). 2024 May;64(5):410-419. doi: 10.1007/s00117-024-01300-5. Epub 2024 Apr 19.

Abstract

CLINICAL ISSUE

Malformations of the central nervous system belong to the most common developmental disorders in humans. The clinical presentation of brain malformations is nonspecific including developmental delay, hypotonia, and/or epilepsy. The great heterogeneity concerning etiology, mechanisms of development and morphology is challenging for diagnosis and classification of brain malformations. Thereby recognizing specific malformations is essential for optimal patient management and prognostic evaluation. The aim of this article is to give an overview of several clinically relevant brain malformations occurring from different disrupted developmental processes in brain formation.

STANDARD RADIOLOGICAL METHODS

Several brain malformations are already diagnosed during routine ultrasound in pregnancy. However pre- and postnatal magnetic resonance imaging remains the gold standard in detecting the partially subtle changes and to classify the malformations.

METHODICAL INNOVATIONS

Advances in pre- and postnatal neuroimaging techniques and increasing investigation of genetic mechanisms underlying brain formation and its abnormalities have led to a better understanding of embryologic development and pathogeneses of brain malformations.

CONCLUSION

Besides patient's history and clinical phenotype, neuroimaging plays a key role in diagnosis. Not always a specific diagnosis can be made, but neuroimaging patterns often enable a focused genetic testing and therefore are revolutionary for etiologic and prognostic assignment. Basic knowledge of brain development facilitates understanding and classifying of structural brain abnormalities.

摘要

临床问题

中枢神经系统畸形是人类最常见的发育障碍之一。脑畸形的临床表现缺乏特异性,包括发育迟缓、肌张力减退和/或癫痫。脑畸形在病因、发育机制和形态学方面具有很大的异质性,这对脑畸形的诊断和分类构成了挑战。因此,识别特定的畸形对于优化患者管理和预后评估至关重要。本文旨在概述几种因脑形成过程中不同发育过程中断而出现的临床相关脑畸形。

标准放射学方法

几种脑畸形在孕期常规超声检查时即可诊断。然而,产前和产后磁共振成像仍然是检测部分细微变化和对畸形进行分类的金标准。

方法学创新

产前和产后神经成像技术的进步以及对脑形成及其异常背后遗传机制的研究不断增加,使人们对脑畸形的胚胎发育和发病机制有了更好的理解。

结论

除了患者病史和临床表型外,神经成像在诊断中起着关键作用。并非总能做出特异性诊断,但神经成像模式通常有助于进行有针对性的基因检测,因此对病因和预后判定具有革命性意义作用。脑发育的基础知识有助于理解和分类脑结构异常。

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