超声对胎儿脑白质软化的诊断价值

目的探讨超声对胎儿脑白质软化(periventricular leukomalacia,PVL)的诊断价值。方法对2012年3月至2015年7月在成都市妇女儿童中心医院产前超声诊断为PVL的4例胎儿超声影像检查资料进行总结,并与胎儿头颅磁共振成像(magnetic resonance imaging,MRI)诊断结果进行对照,分析胎儿PVL的超声表现及超声对PVL的诊断价值。结果胎儿PVL的超声表现为侧脑室旁、半卵圆中心和/或大脑皮下脑白质回声增强、可见无回声或低回声囊腔;4例胎儿第六脑室(verga腔)均扩张。超声诊断的4例胎儿PVL,均为MRI所证实;MRI发现3例大囊性病灶旁有小囊性病灶(直径0.5 cm),超声仅发现2例。4例胎儿产后随访,2例目前生长发育和智力情况未发现异常;1例生长发育迟缓,有运动障碍,易抽搐,智力和语言功能较差;1例生长发育情况可,但有轻微运动障碍,易抽搐。结论超声能在胎儿期较准确的发现胎儿PVL,从而有效地指导临床。

Study on the diagnostic efficacy of craniocerebral ultrasonography for periventricular leukomalacia in fetus

Objective To explore the application value of ultrasonography in diagnosis of periventricular leukomalacia ( PVL) in fetus.Methods The prenatal ultrasound data of 4 fetuses identified as PVL by antenatal ultrasonography examinations between March 2012 to July 2015 in Chengdu Women & Children’ s Central Hospital were analyzed, and were compared with magnetic resonance imaging diagnosis .Results Ultrasonography of fetal PVL showed periventricular and centrum semiovale and /or subcutaneous brain white matter echo enhancement , multiple lumens without echo or with low echo .4 fetuses’ sixth ventricle were dilated .For the 4 cases with periventricular leukomalacia , the ultrasonography results were in accordance with MRI .However , MRI found 3 cases of cystic lesions by follicular lesions(diameter <0.5 cm), ultrasonography found only 2 cases.Postpartum follow-up showed that among the 4 cases, 1 case was found with growth retardation , including movement disorder , convulsions , mental retardation and poor language ability.1 case had a better growth situation but there was slight movement disorder , and convulsions.While the other two cases were with normal growth and intelligence currently .Conclusion The diagnostic efficacy of craniocerebral ultrasonography is relatively high , craniocerebral ultrasonography can be used as a preferred diagnostic method for diagnosis of PVL in fetus .