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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。
Objective To investigate the diagnostic value of ultrasound in fetal periventricular leukomalacia (PVL). Methods From March 2012 to July 2015 in Chengdu Women and Children Hospital, 4 cases of PVL diagnosed by prenatal ultrasound were analyzed with fetal ultrasound imaging and compared with fetal MRI (magnetic resonance imaging) The results were compared, analysis of fetal PVL ultrasound and ultrasound diagnostic value of PVL. Results Fetal PVL showed ultrasound echo in the lateral ventricle, semi-oval center and / or subepithelial white matter. Echo-free or hypoechoic cysts were found in all cases. Fetal ventricular enlargement occurred in all 4 cases. Ultrasound diagnosis of 4 cases of fetal PVL, were confirmed by MRI; 3 cases of cystic lesions found cystic lesions (diameter <0.5 cm), ultrasound only found in 2 cases. Four fetuses were followed up after birth, two cases of current growth and development were not abnormal. One case had growth retardation, dyskinesia, convulsions, poor intelligence and poor language function. One case had growth and development but slight dyskinesia , Easy to convulsions. Conclusion Ultrasound can be more accurate fetal Fetal PVL, which effectively guide the clinical.