Persutte W H
Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver, USA.
Ultrasound Obstet Gynecol. 1998 May;11(5):317-8. doi: 10.1046/j.1469-0705.1998.11050317.x.
Anatomic shortening of the fetal frontal lobe seems to precede microcephaly. Brain size determines the size of the calvarium. The report by Pilu and colleagues provides a physiological basis for recent anatomical observations made regarding microcephaly. Biometry of the frontal lobe of the fetal brain may be a valuable tool for the identification of the fetus at risk for microcephaly. A thorough investigation of the subtle brain anatomy of the developing fetus is necessary in suspicious cases. Prenatal studies have suggested that abnormalities of neurocranial architecture occur in approximately two-thirds of cases. Steinlin and colleagues found a much higher incidence in children (90%) affected by microcephaly. Either the progressive nature of the condition or the improved sensitivity of childhood magnetic resonance imaging (used in their study) over prenatal ultrasonography for the detection of subtle brain abnormalities may account for this difference. However, high-resolution ultrasonographic instruments should allow for the detection of many accompanying neuroanatomic abnormalities, possibly before the markedly small calvarium is seen. Finally, Pilu and colleagues have shown that the underlying conditions that may predispose to brain atrophy may be recognizable with Doppler ultrasonography.
胎儿额叶的解剖学缩短似乎先于小头畸形。脑的大小决定颅骨的大小。皮卢及其同事的报告为近期关于小头畸形的解剖学观察提供了生理学依据。胎儿脑额叶的生物测量可能是识别有小头畸形风险胎儿的一项有价值的工具。在可疑病例中，对发育中胎儿细微脑解剖结构进行全面调查是必要的。产前研究表明，约三分之二的病例存在神经颅结构异常。施泰林及其同事发现，患小头畸形的儿童中这一发生率要高得多（90%）。这种差异可能是由于病情的进展性，或者是他们研究中使用的儿童磁共振成像比产前超声对细微脑异常检测的敏感性更高。然而，高分辨率超声仪器应该能够检测到许多伴随的神经解剖学异常，可能在明显小的颅骨出现之前就能检测到。最后，皮卢及其同事已经表明，通过多普勒超声可能识别出可能易导致脑萎缩的潜在状况。
