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•专家论坛•颅内囊性结构（室管膜下囊肿、布莱克 囊肿、韦氏腔、中间帆腔）产前超声报告与解读李胜利 廖伊梅 文华轩DOI ：10.3877/cma.j.issn.1672-6448.2018.05.002基金项目：国家自然科学基金（81771598）；深圳市科技计划 项目（JSGG20160428154812749，JCYJ20170307091013214）作者单位：518028 南方医科大学附属深圳市妇幼保健院通信作者：李胜利，Email ：lishengli63@随着产前超声技术的进步，越来越多的胎儿颅内囊性结构被超声医师发现，如室管膜下囊肿（subependymalcysts ）、Blake ′s pouch 囊肿、韦氏 腔（cavum Vergae ，CV ）、中间帆腔（cavum velum interpositum ，CVI ），这些结构有的是正常胚胎发育过程、有的是正常潜在腔隙的扩张、有的出生后可自行吸收、有的被视为正常变异而持续存在，对以上颅内囊性结构的来源及临床预后的错误认识，可能导致误诊，甚至不必要的引产。
而随着产前超声图像质量和成像技术的提高，对胎儿解剖结构的观察更细致，许多产前超声医师以观察到这些结构为异常，导致过度报告，会引起孕妇焦虑，同时给妇产科医师带来困扰，引起不必要的医疗纠纷。
本文对产前超声可显示的4种颅内囊性结构进行分析解读，以期为产前超声医师、妇产科医师提供 参考。
一、室管膜下囊肿室管膜下囊肿（subependymal cysts ）又称室管膜下假性囊肿（subependymal pseudocysts ），是指沿着侧脑室前角下壁或临近侧脑室前角侧壁的囊性结构，少见于侧脑室颞角或枕角内壁的囊性结构［1］。
囊壁缺乏上皮层，因此也称为假性囊肿。
（一）病因及发生率新生儿颅脑超声检查时发现室管膜下囊肿并不少见，国外文献报道足月健康新生儿出生后第1天 经前囟超声检查时，室管膜下囊肿的发生率为0.5%~5%［2-3］，国内文献报道正常新生儿室管膜下囊肿的发生率为7.6%~8.19%［4-5］，疾病新生儿室管膜下囊肿的发生率为20.54%［5］。
超声对新生儿室管膜下病变的诊断价值朱芮;王捷荣;董志文;王晓磊【摘要】目的：分析超声对新生儿室管膜下病变的诊断价值。
方法：选取2013-05-2017-12期间我院1624例出生1wk内住院新生儿,以新生儿颞囟、前囟为声窗,探查尾状核头部与丘脑交界位置的室管膜下区的二维超声（2 DUS）表现,依据2 DUS结果将新生儿分为正常新生儿（正常对照组）、室管膜下病变新生儿（室管膜下囊肿组、室管膜下出血液化组、室管膜下出血组）,采用彩色多普勒超声测定正常对照组与室管膜下不同病变组脑患侧以及室管膜下不同病变组脑患侧与健侧之间大脑中动脉各血流参数［舒张期末最大血流速度（Vd）、收缩期末最大血流速度（Vs）］水平。
结果：经2 DUS检查显示1624例新生儿中考虑为室管膜下病变新生儿406例（其中室管膜下囊肿126例、室管膜下出血液化119例、室管膜下出血161例）、正常新生儿1218例。
正常新生儿2 DUS表现为尾状核头部与丘脑交界位置的室管膜下区出现平滑细线状的稍强回声,无明显异常突起;室管膜下囊肿2 DUS表现为室管膜下区出现多个或单个无回声区或者葡萄串样改变无回声区,壁薄且光滑;室管膜下出血液化2 DUS表现为室管膜下区出现类圆形或圆形低回声,内可见片状无回声区,壁毛糙;室管膜下出血2 DUS表现为室管膜下区出现稍不均匀强回声团。
室管膜下囊肿组脑患侧大脑中动脉Vd、Vs水平高于对照组,且高于室管膜下出血液化与室管膜下出血组（ P 〈 0.05 ）,室管膜下出血液化组脑患侧大脑中动脉Vs水平低于对照组（ P 〈 0.05 ）; 室管膜下囊肿组脑患侧大脑中动脉Vd、Vs水平高于健侧（ P 〈 0.05 ）,室管膜下出血液化组脑患侧大脑中动脉Vs水平低于健侧（ P 〈 0.05 ）;218例患儿1wk后进行2 DUS复查显示室管膜下囊肿、室管膜下出血患儿在短期内病灶、回声均无显著变化;而室管膜下出血液化患儿中病灶减少39例,回声减低20例,病灶无变化12例。
［5］ 陈任政，张刚，成官迅，等. 多发性骨髓瘤的临床与影像诊断［J］.南方医科大学学报，2009，29（4）: 811-813.图像质量不佳，注射部位、尿液污染；（2）病灶位于盆骨，受膀胱放射性干扰；（3）有骨骼修复、植入史；（4）接受放疗不久，【摘要】目的 探讨新生儿室管膜下囊肿的超声表现，分析发病原因及病情转归。
方法 选择我院产科出生的428例新生儿，产后24小时内常规颅脑超声检查，扫查新生儿头颅冠状面和矢状面，观察新生儿颅脑室管膜下区域的超声表现。
结果 428例新生儿共检出室管膜下囊肿32例，占7.48%（32/428），有25例呈现典型的超声表现：在新生儿的侧脑室前角下方及丘脑尾状核沟均可见小囊肿，囊肿呈单发或者多发，囊壁较薄，多个小囊肿呈现蜂窝状或者葡萄串状。
其余7例不典型者为室管膜下出血吸收后所致囊肿，超声表现为管状面上在新生儿的侧脑室前角下方及丘脑尾状核沟可见中央无回声，周边回声较强，囊壁较厚的多个囊样结构。
结论 超声可作为诊断新生儿室管膜下囊肿的首选方法。
【关键词】超声检查；临床意义；新生儿颅脑；室管膜下囊肿【中图分类号】R722.1 【文献标识码】B 【文章编号】1674-9316（2015）19-0165-02doi:10.3969/j.issn.1674-9316.2015.19.127The Ultrasonic Manifestation and Clinical Significance of Neonatal Subependymal Cyst GUO Xing Department of Ultrasound of Nanyang Central Hospital，Nanyang 473000，China 【Abstract】Objective To investigate the ultrasonic manifestation，causes and clinical outcomes of neonatal subependymal cyst. Methods 428 newborns within 24 hours of postpartum were detected by ultrasound with a special probe of neonatal craniocerebral inspection.A series of coronal and sagittal scan were conducted tran anterior fontanel，which emphasized on the zone of subependymal bordering between head of caudate nucleus and thalamus，so as to find pathological changes and the ultrasonographic findings．Results In 428 newborns，we found 32（7.48%，32/428）cases of subependymal cyst，25 cases showed typical uhrasonographic findings that bellowing the anterior angle of latera ventricle single or multiple noechoareas could be seen by coronal scan，boundary clear and wall thin，with honeycomb and grapecluster appearing in multiple ones.By sagittal scan，they could be detected in thalamus caudate nuclei ditch.7 cases were cysts came from absorption of subependymal bleeding，by coronal scan bellowing the anterior angle of latera ventricle and by sagittal scan in thalamus caudate nuclei ditch，multiple noechoareas could be seen，and ultrasonogram showed anechoic in the center，hyperechoic around.Conclusion Craniocerebral ultrasonic can he used as the preferred examination to diagnose neonatal subependymal cyst，investigate the pathogeny and the prognosis，and provide the basis for the clinical treatment．【Key words】Neonatal craniocerebral，Subependymal cyst，Ultrasonic manifestation，Clinical significance新生儿室管膜下囊肿的超声表现郭 兴头颅超声诊断新生儿室管膜下囊肿敏感性较高，并可以对不同致病因素所致室管膜下囊肿作出明确诊断，本研究主要选择我院产科出生的428例新生儿，产后24小时内常规颅脑超声检查，具体报道如下。
2019年3月胎儿卵巢囊肿MRI 表现及临床治疗转归（附3例报告）张翼1，刘乐2，张静1*（1.西北妇女儿童医院医学影像中心，陕西西安，710061；2.西安交通大学第二附属医院影像科，陕西西安，710004）摘要：胎儿时期卵巢囊肿主要因激素作用而形成，较小的囊肿可于产后自行消失；较大的囊肿或复杂囊肿多需实施手术进行切除。
胎儿卵巢囊肿有其特有的磁共振成像（MRI ）表现，因此掌握胎儿卵巢囊肿信号特点，对产前诊断、胎儿预后及手术评估均具有重要意义。
本文对本院收治的3例胎儿卵巢囊肿MRI 信号特点进行分析，探讨胎儿卵巢囊肿MRI 表现及临床治疗转归，旨在为临床治疗卵巢囊肿提供可靠依据。
关键词：胎儿；卵巢囊肿；磁共振成像中图分类号：R737.31文献标志码：A文章编号：2096-1413(2019)09-0145-02MRI manifestations and clinical treatment outcomes of fetal ovarian cysts(3cases report)ZHANG Yi 1,LIU Le 2,ZHANG Jing 1*(1.Medical Imaging Center,Northwest Women's and Children's Hospital,Xi'an 710061;2.Imaging Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)ABSTRACT:Ovarian cysts in fetal period are mainly formed by hormone action.Smaller cysts can disappear spontaneously after delivery;larger cysts or complex cysts need to be removed surgically.Fetal ovarian cysts have their own magnetic resonance imaging (MRI)features.Therefore,it is important to master the signal characteristics of fetal ovarian cysts for prenatal diagnosis,fetal prognosis and surgical evaluation.In order to provide reliable basis for clinical treatment of ovarian cysts,the characteristics of MRI signals of 3cases of fetal ovarian cysts admitted in our hospital were analyzed,and the MRI manifestations and clinical treatment outcome of fetal ovarian cysts were discussed.KEYWORDS:fetus;ovarian cysts;magnetic resonance imagingDOI :10.19347/ki.2096-1413.201909057作者简介：张翼（1989-），女，汉族，山西运城人，住院医师，硕士。
・36・中国临床医学影像杂志2019年第30卷第1期J Chin Clin Med Imaging,2019.Vol.30,No.l 胎儿先天性胆总管囊肿的产前超声诊断及预后评估张普庆，吴青青，王莉，梁娜，韩吉晶，张铁娟，马玉庆，姚苓，孙娟(首都医科大学附属北京妇产医院超声科，北京100026)［摘要］目的：通过分析胎儿先天性胆总管囊肿的声像图特点，定期宫内监测、追踪随访结果，探讨产前超声的诊断价值、鉴别诊断及临床意义，为产前咨询及新生儿处理提供依据。
方法：收集胎儿胆总管囊肿的病例45例，分析声像图特征、比较出生前后变化、对比病理结果等资料，总结预后与转归。
结果：45例中失访2例，最终43例纳入本研究。
出生后行新生儿腹部超声检查提示为胆总管换肿35例，其中34例经手术病理证实，1例由于手术延迟因核黄疸死亡，产前产后超声诊断符合率为81.4% (35/43)o误诊7例，误诊率为16.3%(7/43),其中肝囊肿4例，先天性胆道闭锁2例，卵巢囊肿1例，均行手术治疗；引产1例(1/ 43,2.3%)。
结论：先天性胆总管囊肿在产前可通过超声检出，为可治性囊肿，出生后及时、尽早的手术治疗者预后较好，手术延迟会导致肝脏不可逆损伤。
［关键词］胆总管囊肿；胎儿疾病；超声检查，产前［中图分类号］R575.7；R714.5；R445.1［文献标识码］A［文章编号］1008-1062(2019)01-0036-03DOI:10.12117/jccmi.2019.01.011The prenatal ultrasound diagnosis and evaluation of the prognosis of fetal congenital choledochal cysts ZHANG Pu-qing,WU Qing-qing,WANG Li,LIANG Na,HAN Ji-jing,ZHANG Tei-juan,MA Yu-qing,YA0Ling,SUN Juan(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital Affiliated to Cap t ied Medical University,Beijing100026,China)Abstract:Objective：By analyzing prenatal imaging characteristics,regular intrauterine monitoring,and following up of fetuses with congenital choledochal cysts,to explore the diagnostic value,differential diagnosis and clinical significance of prenatal ultrasound,thus providing the basis for prenatal consultation and neonatal treatment.Methods：45cases of fetuses with choledochal cysts were recruited in this study.Their prenatal ultrasonography were analyzed and compared with the postpartum follow-up results,pathological results,thus the prognosis and outcome were summarized.Results：2of the45cases were lost to followed up.43cases were recruited in this study.35of43cases were diagnosed with congenital choledochal cysts by neonatal abdominal ultrasound examination,with34cases confirmed by surgical pathology of congenital choledochal cysts and 1case dying of keniicterus due to delay of surgical intervention.The prenatal ultrasound diagnosis coincidence rate was 81.4%(35/43).Seven cases were misdiagnosed,with a misdiagnosis rate of16.3%(7/43),including4cases of hepatic cysts,2 cases of congenital biliary atresia and1case of ovarian cyst,all of which were treated with surgery.One case(l/3, 2.3%)had induced labor.Conclusions：Congenital choledochal cysts of fetuses can be detected by prenatal ultrasonography and are curable.Patients having surgical treatment timely and early after birth will have a good prognosis.Delayed surgery can cause irreversible damage to the liver.Key words：Choledochal cyst;Fetal diseases;Ultrasonography,prenatal随着产前超声诊断技术水平的提高及二孩儿政策的放开，胎儿先天性胆总管囊肿的检岀率也逐渐增高，随着新生儿畸形手术矫治水平的提高,孕妇选择继续妊娠及手术治疗的比例也越来越多。
学术论著中国医学装备2023年11月第20卷第11期 China Medical Equipment 2023 November V ol.20 No.11*基金项目：安徽省自然科学基金(1908085MH205)“胎儿淋巴水囊瘤与染色体异常的相关性研究及妊娠结局分析”①淮北市妇幼保健院超声科 安徽 淮北 235000②淮北市妇幼保健院新生儿科 安徽 淮北 235000作者简介：岳静，女，(1984- )，本科学历，主治医师，从事胎儿弥漫性淋巴水囊瘤的诊断及研究工作。
[文章编号] 1672-8270(2023)11-0077-04 [中图分类号] R445.1 R733.4 [文献标识码] AAnalysis on the correlation between the NT thickening and CCH of ultrasound examination and chromosomal abnormality, and between them and the pregnancy outcomes/YUE Jing, WANG Hui, CHEN Peng, et al//China Medical Equipment,2023,20(11):77-80.[Abstract] Objective: T o explore the correlations between the thickening of nuchal translucency (NT) and cervical cystic hygroma (CCH) of ultrasound examination and chromosomal abnormalities, and between them and pregnancy outcomes. Methods: A total of 64 pregnant women with CCH admitted to the hospital were selected, and all of them underwent ultrasound examination. The prenatal intervention treatment was selectively performed based on the results of ultrasound. Whole genome chromosome microarray (CMA) analysis or chromosome karyotype analysis were performed separately to analyze the results of gene chip, chromosome detection and pregnancy outcomes of CCH pregnant women. Results: The 64 pregnant women were confirmed as CCH by prenatal ultrasound examination, and all of the measured fetal NT values were ≥ 2.5 mm, with an average thickness of (5.43 ± 1.19) mm. In 64 pregnant women, the NT values of 33 fetuses were between 2.5 and 3.0 mm, and the NT values of 19 fetuses were between 3.1 and 3.5 mm, and that of 12 fetuses were greater than 3.5 mm. The adverse pregnancy outcomes of the fetuses whose NT values were greater than 3.5 mm were significantly higher than those whose NT values were between 3.1 and 3.5 mm and those whose NT values were between 2.5-3.0 mm, and the differences were statistically significant (x 2=3.651, x 2=2.459, P <0.05), respectively. In 64 pregnant women, the chromosomes of 38 fetuses were abnormalities (1 case was induced due to sacrococcygeal spina bifida, and 37 cases terminated pregnancy), the results of gene chip examinations of 8 cases were abnormalities (1 case was vaginal delivery and healthy, and 1 case was vaginal delivery and health, and 1 case was spontaneous abortion, and 5 cases were termination of pregnancy). The examination results of chromosome and chip did not appear abnormalities in 18 fetuses (8 fetuses without abnormalities as ultrasound examination were live birth, and 1 case was spontaneous abortion, and 1 case was stillbirth, and 6 cases were termination of pregnancy, 2 cases were live birth). Conclusion: It is necessary to conduct ultrasound examination for NT values of CCH pregnant women as soon as possible, and the comprehensive judgement of that with chromosome and gene analysis for abnormal pregnant women can predict the pregnancy outcome.[Key words] Ultrasound; Nuchal translucency (NT); Cervical cystic hygroma (CCH); Chromosomal abnormality; Pregnancy outcome[First-author 's address] Ultrasound Department, Huaibei Maternal and Child Health Care Hospital, Huaibei 235000, China.[摘要] 目的：探索超声检测颈部透明层(NT)增厚、胎儿淋巴水囊瘤(CCH)与染色体异常以及妊娠结局的相关性。
新生儿室管膜下囊肿对后期生长发育影响的队列研究陈一露;张丽范;郭小芳;张霞;陈慧明【期刊名称】《现代医院》【年(卷),期】2011(011)010【摘要】目的观察新生儿室管膜下囊肿对婴幼儿后期生长发育的影响.方法本院经头颅B超诊断的1 617例室管膜下囊肿新生儿作为随访对象,其中足月儿1 396例,早产儿221例.两组新生儿分别在生后4、8和12个月进行体格测量,12个月利用CDCC婴儿发育量表进行发育评价,并分别与同期正常婴儿进行比较.结果足月囊肿组4、8和12个月的体重、身长、头围以及1岁时智力和运动发育指数与对照组无显著性差异(p>0.05),而早产囊肿组患儿4和8个月龄体重、身长以及1岁时智力和运动发育指数显著低于早产儿对照组(p<0.05).结论室管膜下囊肿对足月儿生长发育影响不大,而对早产儿影响则较为明显,应加强对早产患儿后期的监测工作.【总页数】3页(P15-17)【作者】陈一露;张丽范;郭小芳;张霞;陈慧明【作者单位】江门市新会区疾病预防控制中心,广东江门,529100;江门市新会区妇幼保健院,广东江门,529100;江门市新会区妇幼保健院,广东江门,529100;江门市新会区妇幼保健院,广东江门,529100;江门市新会区妇幼保健院,广东江门,529100【正文语种】中文【相关文献】1.新生儿室管膜下囊肿的影像表现分型及危险因素分析 [J], 李彦彦;穆靓;孙亲利;高洁;王苗苗;杨健2.新生儿室管膜下囊肿的发生率和影响因素调查 [J], 钱继红3.颅脑超声结合Torch检测结果分析新生儿室管膜下囊肿的意义 [J], 黄帝;尤沛;居燕;钱晴4.颅脑超声结合Torch检测结果分析新生儿室管膜下囊肿的意义 [J], 黄帝;尤沛;居燕;钱晴;5.新生儿室管膜下囊肿的研究进展 [J], 李智;张绍梅因版权原因，仅展示原文概要，查看原文内容请购买。
超声评估指标对胎儿腹部囊肿诊断价值的研究摘要］目的制定胎儿腹部囊肿的超声评估指标，包括囊肿位置、毗邻、数目、大小变化、形态、张力、囊壁厚度、囊壁连续性、囊内回声及活动度，并探讨应用超声评估指标诊断胎儿腹部囊肿的价值。
方法将超声检查人员分成常规组和评估组，常规组按常规方法超声检查胎儿腹部囊肿，评估组参照胎儿腹部囊肿评估指标进行超声检查，采用双盲法检查胎儿腹部囊肿65例，包括胎儿胆总管囊肿、小肠重复畸形、肠系膜囊肿、大网膜囊肿、卵巢囊肿，对其超声图像进行分析，总结各种胎儿腹部囊肿的超声图像特征，从而对超声评估指标诊断胎儿腹部囊肿价值作出评价。
结果本组65例胎儿腹部囊肿，其中，胆总管囊肿17例，小肠重复畸形9例，肠系膜囊肿7例，大网膜囊肿2例，卵巢囊肿30例。
分别经后期复查、其他影像学检查、产后检查、手术或引产解剖等得以明确诊断。
常规组，超声诊断正确44例，诊断为腹部囊肿13例，误诊6例，漏诊2例。
超声正确诊断率67.69%，诊断不明确占20.00%，误诊、漏诊占12.31%。
评估组，超声诊断正确59例，诊断为腹部囊肿2例，误诊3例，漏诊1例。
超声正确诊断率90.77%，诊断不明确占3.08%，误诊、漏诊占6.15%。
评估组超声正确诊断率显著高于常规组，P＜0.01，差异有统计学意义。
结论超声评估指标的应用，更新了超声检查胎儿腹部囊肿的思路，由于评估内容更为全面、系统、规范，从而丰富了超声检查信息，使诊断结论更为可靠，它有助于减少诊断不明确及误诊情况，为胎儿腹部囊肿的超声诊断，提供了一个具有重要临床价值的方法。
［关键词］胎儿超声评估指标腹部囊肿［Abstract］ Purpose To set Ultrasound assessment index of fetal abdominal cysts, including cystic mass position, adjacent, number, size， shape, tension， thickness of cyst wall，cyst wall continuity，cyst internal echo and activity degree，and also discuss the diagnosis value of ultrasound assessment indexes in fetal abdominal cyst. Methods Ultrasound department staffs were divided into routine group and evaluation group. The routine group was examined by conventional method of ultrasound examination of fetal abdominal cyst. Evaluation group was examined by ultrasoundwith reference to fetal abdominal cysts assessment indexes. 65 cases of fetal abdominal cysts were examined by Double blind method，including fetus choledochal cysts ，duplication of the small intestine ，mesenteric cyst，greater retinal cyst，ovarian cyst. Ultrasound images were analyzed, summed up the ultrasonic image features of various fetal abdominal cysts, and assessed the diagnosis value of ultrasound assessment indexes in fetal abdominal cysts. Results There were 65 cases fetus ultrasound fetal abdominal cyst in the group, including 17 cases of choledochal cysts, 9 cases of duplication of the small intestine，7 cases of mesenteric cyst，2 cases of greater retinal cyst, 30 cases of ovarian cyst. Through the late reexamine, other imaging examinations, postpartum check, operation or Induced after labor autopsy and so on, these cases have also been diagnosed. In the routine group, 44 cases were diagnosed correctly by ultrasound, 13 cases were diagnosed as abdominal cysts, 6 cases were misdiagnosed and 2 cases were missed diagnosis. The correct diagnosis rate of ultrasound was 67.69%, the unclear diagnosis rate was 20%, misdiagnosis and missed diagnosis rate were 12.31%. In the evaluation group, 59 cases were diagnosed correctly by ultrasound, 2 cases were diagnosed as abdominal cysts, 3 cases were misdiagnosed and 1 cases were missed diagnosis. The correct diagnosisrate of ultrasound was 90.77%, the unclear diagnosis rate was 3.08%, misdiagnosis and missed diagnosis rate were 6.15%. The rate of correct diagnosis in the evaluationgroup was significantly higher than that in the routine group, P＜0.01. There was a significant difference. Conclusion The application of ultrasound assessment index is a new idea of ultrasound examination of fetal abdominal cysts. Because of the more comprehensive, systematic, standardized content of the assessment, it will enrich the ultrasonic inspection information and make the diagnosis result more reliable. It is helpful to reduce unclear diagnosis and misdiagnosis. It provides an important clinical value for ultrasound diagnosis of fetal abdominal cyst.［Keywords］ Fetus；Ultrasound；Evaluation indexes；Abdominal cystic mass胎儿腹部囊肿种类繁多，由于囊肿可来源于消化、泌尿生殖系统以及腹腔、腹膜后等部位，由于囊肿来源不定、超声图像复杂各异，因而致使超声诊断困难［1-3］，或部分胎儿腹部囊肿需要到婴儿时期方得以诊断［4］。
胎儿室管膜下囊肿的超声表现、临床结局与预后的探讨李玲;李童;林碧芬;赖慧华【摘要】目的:本研究对胎儿室管膜下囊肿的超声表现、临床结局与预后进行探讨,旨在提高临床诊断的有效性,并改善胎儿的预后.方法:选取我院2014年6月～2015年6月于超声检测中确诊为室管膜下囊肿的胎儿76例,对这些胎儿的临床资料进行回顾性的分析,探讨这些胎儿室管膜下囊肿病例的声像图诊断的特点和临床的结局.结果:76例室管膜下囊肿胎儿的囊肿均处于侧脑室前角的外部或者其与体部交界处的外部,边界较清晰且壁薄;56例为双侧,20例为单侧;42例表现为串珠样或者多发囊肿,34例表现为单发囊肿.此外,合并妊娠期高血压的孕妇有2例,合并胎儿异常的孕妇有12例.后期随访发现,合并畸形引产的有3例;早产2例(其中1例神经系统发育落后,另1例不满28周出生后便死亡);胎死宫内2例,合并脑室扩张5例,后期随访后发现1例神经系统发育落后,其余68例后期随访后发现均为健康发育.结论:采用超声检查可准确诊断胎儿室管膜下囊肿,排除其他合并畸形或者相关异常的室管膜下囊肿,患儿的短期预后较好.【期刊名称】《实用中西医结合临床》【年(卷),期】2017(017)002【总页数】2页(P134-135)【关键词】胎儿;室管膜下囊肿;临床结局;超声表现【作者】李玲;李童;林碧芬;赖慧华【作者单位】广东省佛山市顺德区妇幼保健院超声科佛山528300;广东省佛山市顺德区妇幼保健院超声科佛山528300;广东省佛山市顺德区妇幼保健院超声科佛山528300;广东省佛山市顺德区妇幼保健院超声科佛山528300【正文语种】中文【中图分类】R445.1室管膜下囊肿指胚胎生发层基质发生的囊肿，由于此种囊肿未出现上皮细胞覆盖的情况，因此可称之为假性囊肿[1]。
在临床诊疗过程中，新生儿室管膜下囊肿超声诊断的研究比较多，一般在胎儿出生后的24 h内头颅超声便能够准确检出，推测室管膜下囊肿在胎儿期便已发生。
室管膜下囊肿的产前超声诊断王海旺【摘要】Objective To investigate the ultrasonographic features and diagnostic methods of fetal ventricular tube membrane cyst. Methods When the transverse section of the brain was scanned, the lateral and lateral ventricles of the anterior horn of the lateral ventricle and the lateral ventricles of the lateral ventricles were observed. Results In our hospital, 49 cases were detected by ultrasound, 7 cases were induced labor, 42 cases were 24 h after delivery, 2 cases were lost, all were single, and the other 40 cases were all consistent with the results of prenatal ultrasound. Conclusion It is convenient, quick and accurate to master the correct method of examination in the diagnosis room, which is convenient, rapid and accurate.%目的：探讨胎儿室管膜囊肿的超声表现及诊断方法。
方法扫查颅脑横切面时，着重观察侧脑室前角与体部交界处外侧及侧脑室前角外侧。
产前超声诊断胎儿室管膜下囊肿摘要目的探討产前超声对胎儿室管膜下囊肿的诊断价值。
方法对产前超声发现的42例胎儿室管膜下囊肿声像图特征及预后进行回顾性分析。
结果42例胎儿室管膜下囊肿均于中晚孕期发现，囊肿在头颅横切面时位于侧脑室前角外侧或侧脑室前角与体部交界处的外侧；在头颅冠状面时可见位于侧脑室前角和体部下方；在头颅旁矢状切面时可见位于尾状核头与丘脑交界的室管膜下区，壁薄，边界清，部分内可见分隔，无血流信号，直径3～18 mm；单侧发生13例，双侧发生29例；单发囊肿19例，多发囊肿23例。
合并其他颅内及颅外发育异常4例，均引产；单纯性室管膜下囊肿38例，引产2例；20例孕妇行产前超声复查，囊肿消失2例，复查间隔平均孕4周，34例产后颅脑超声检查或磁共振（MR）检查，均证实室管膜下囊肿。
随访至出生后1～3个月体检未见发现异常。
结论胎儿室管膜下囊肿有明确的发生部位及特征性声像图表现，产前超声可以基于明确的发生部位及特征性声像图表现对胎儿室管膜下囊肿进行诊断。
单纯性室管下囊肿的预后短期随访未发现异常。
关键词胎儿；室管膜下囊肿；超声检查；预后Prenatal ultrasound in diagnosis of fetal subependymal cysts WANG Xiao-hua. Department of Ultrasound，Zhongshan City Affiliated Boai Hospital of Southern Medical University，Zhongshan 528400，China【Abstract】Objective To investigate diagnostic value by prenatal ultrasound for fetal subependymal cysts. Methods A retrospective analysis was made on ultrasonogram features and prognosis in 42 fetal subependymal cysts cases detected by prenatal ultrasound. Results All 42 cases of fetal subependymal cysts were discovered in middle-late pregnancy. Head cross section showed cysts outside anterior horn of lateral ventricle or outside junction of anterior horn of lateral ventricle and somatic part；head coronal plane showed cysts underneath anterior horn of lateral ventricle and somatic part；lateral head sagittal section showed cysts underneath ependyma in junction of head of caudate nucleus and thalamus，with thin wall，clear boundary，separation in some cysts，no blood flow signal，and diameter as 3～18 mm. There were 13 unilateral cases and 29 bilateral cases；19 cases with single cysts and 23 cases with multiple cysts. There were 4 induced labor cases with other complicated intracranial and extracranial dysplasia. Among 38 cases with single subependymal cysts，there were 2 induced labor cases. Among 20 cases in prenatal ultrasound reexamination by equispaced 4 weeks，there were 2 cases with disappeared cysts. All 34 cases in postnatal craniocerebral ultrasound examination or magnetic resonance examination were confirmed as subependymal cysts. Follow-up till postnatal 1～3 months showed no abnormality. Conclusion Due to specific occurrence site and characteristic ultrasonogram manifestation of fetal subependymal cysts，prenatal ultrasound can provide diagnosis of fetal subependymal cysts on the basis of its specific occurrence site and characteristic ultrasonogram manifestation.Short-term prognosis follow-up for single subependymal cysts shows no abnormality.【Key words】Fetal；Subependymal cysts；Ultrasonic examination；Prognosis室管膜下囊肿是指发生在尾状核头部与丘脑交界处、侧脑室前角旁的室管膜下区域即胚胎生发层基质的囊肿[1]，是一种少见的脑部良性囊肿。
新生儿室管膜下囊肿对后期生长发育影响的队列研究陈一露;张丽范;郭小芳;张霞;陈慧明【摘要】目的观察新生儿室管膜下囊肿对婴幼儿后期生长发育的影响.方法本院经头颅B超诊断的1 617例室管膜下囊肿新生儿作为随访对象,其中足月儿1 396例,早产儿221例.两组新生儿分别在生后4、8和12个月进行体格测量,12个月利用CDCC婴儿发育量表进行发育评价,并分别与同期正常婴儿进行比较.结果足月囊肿组4、8和12个月的体重、身长、头围以及1岁时智力和运动发育指数与对照组无显著性差异(p>0.05),而早产囊肿组患儿4和8个月龄体重、身长以及1岁时智力和运动发育指数显著低于早产儿对照组(p<0.05).结论室管膜下囊肿对足月儿生长发育影响不大,而对早产儿影响则较为明显,应加强对早产患儿后期的监测工作.【期刊名称】《现代医院》【年(卷),期】2011(011)010【总页数】3页(P15-17)【关键词】新生儿;室管膜下囊肿;生长发育;队列研究【作者】陈一露;张丽范;郭小芳;张霞;陈慧明【作者单位】江门市新会区疾病预防控制中心,广东江门,529100;江门市新会区妇幼保健院,广东江门,529100;江门市新会区妇幼保健院,广东江门,529100;江门市新会区妇幼保健院,广东江门,529100;江门市新会区妇幼保健院,广东江门,529100【正文语种】中文室管膜下囊肿是一种常见的新生儿脑损伤，它由多种因素引起，与胎儿时期宫内窘迫密切相关，可对新生儿、婴儿造成一定的损害［1］。
国内已有研究表明脑室管膜下囊肿患儿的体格和智能发育在生后1年内均有不同程度的落后，并且这种落后可持续至学龄前;国外相关研究也提示伴有室管膜下囊肿的高危新生儿大部分有运动发育迟缓或者障碍。
目前国内脑室管膜下囊肿患儿远期随访研究相对较少，我科2008年4月～2010年1月共21个月对筛查出的脑室管膜下囊肿新生儿进行了跟踪随访，现将调查结果报告如下。
作者单位：256603 滨州医学院临床学院小儿外科 （冯文玉 崔广和傅廷亮）通讯作者：傅廷亮 E-mail：drfutl@胎儿卵巢囊肿的诊断和处理进展冯文玉 崔广和 傅廷亮[关键词] 胎儿；卵巢囊肿；进展胎儿卵巢囊肿少见，但会影响卵巢的发育，如果发生扭转，则会导致卵巢缺失。
随着产前超声的发展，胎儿卵巢囊肿的发现率增加，目前胎儿卵巢囊肿的处理尚存在争议。
本文就胎儿卵巢囊肿的诊断和治疗进展综述如下。
1975年Valenti等[1]首先描述了胎儿卵巢囊肿，认为胎儿卵巢囊肿可能是由于母体雌激素分泌过多造成。
近年来，胎儿卵巢囊肿的发病率上升，可能与产前超声诊断的广泛应用有关。
除肾脏和胃肠道先天性畸形外，胎儿卵巢囊肿是产前检查发现的常见腹内肿物[2]。
正常新生儿卵巢可见小的囊肿，普遍认为囊肿直径大于2cm时即属于病理性[3]。
较大的卵巢囊肿会影响卵巢发育，甚至发生卵巢扭转、坏死，最终导致卵巢缺如。
因此胎儿囊肿的及时发现和合理处理具有重要的临床意义。
1 胎儿卵巢囊肿的原因胎儿期卵巢囊肿不常见，其发病原因尚未完全明了。
卵巢组织来自三个胚层：泌尿生殖嵴的间质，覆盖泌尿生殖嵴的生发上皮和卵黄囊内的生殖细胞。
女性胎儿性腺发育最早始于孕6～孕8周，卵泡随后由泌尿生殖嵴间质形成的卵泡膜包绕[4]。
孕20周胎儿卵巢中的卵原细胞数量达高峰，约有600～700万个，之后数量下降，出生时约含70～200万个初级卵母细胞，其中绝大部分进入第一次减数分裂前期的双线期，并长期停滞在此阶段。
这一时期母体雌激素、绒毛膜促性腺激素（HCG）和胎儿促性腺激素促使卵泡发育。
然而激素的过度产生，诱发了卵巢囊肿的形成。
胎儿期卵巢囊肿的发生可能与母体内激素生成失调有关[5]。
目前认为母亲患子痫、糖尿病、多胎妊娠及妊娠并发同种免疫反应时，胎盘产生大量HCG，胎盘激素分泌失调可导致卵巢囊肿的发生[6-7]。
产前超声检查可发现孕28～32周的胎儿卵巢囊肿。
·经验交流·作者单位：５１１４００广州市，广东省妇幼保健院超声诊断科通信作者：马小燕，Ｅｍａｉｌ：ｍｘｙｍ２００１＠１２６．ｃｏｍ胎儿室管膜下囊肿的超声诊断及临床结局尚宁肖珍张玉兰郭艳霞王丽敏马小燕摘要目的探讨胎儿室管膜下囊肿的超声表现、临床结局及预后。
方法回顾性分析我院产前超声检出的胎儿室管膜下囊肿１３５例，分析所有病例声像图表现特点及临床结局。
结果囊肿均位于侧脑室前角外侧或侧脑室前角与体部交界处的外侧，壁薄，边界清。
单侧发生４１例，双侧发生９４例。
表现为单发囊肿６１例，多发或串珠样囊肿７４例。
其中３例孕妇合并妊娠期高血压疾病，１９例合并胎儿异常。
成功随访１０２例，４例因合并严重畸形引产，３例早产（其中１例出生后死亡，２例随访健康），２例胎死宫内，１例合并脑室扩张者随访至２岁智力发育迟缓，余９２例随访至２岁均健康发育。
结论超声能准确诊断胎儿室管膜下囊肿。
排除其他相关异常及合并畸形的单纯室管膜下囊肿，短期预后良好。
关键词超声检查；胎儿；室管膜下囊肿；预后［中图法分类号］R714.53；R445.1［文献标识码］AUltrasonic diagnosis and clinical outcome of fetal subependymal cystsShang Ning ，Xiao Zhen ，Zhang Yulan ，Guo Yanxia ，Wang Limin ，Ma Xiaoyan Department of Ultrasound ，Guangdong Women and Children Hospital ，Guangzhou 511400，ChinaABSTRACT Objective To explore ultrasonic appearance,clinical outcome and prognosis of fetal subependymal cysts.MethodsSonographic features and clinical outcome in 135fetuses with subependymal cysts were analyzed retrospectively.Results All the cysts were located in the lateral region of anterior horn of lateral ventricle or in the lateral region between anterior horn and body of lateral ventricle.The cysts had thin walls and clear boundaries.Forty -one cases were located in unilateral ventricle ，and 94cases were located in bilateral ventricles.Sixty-one cases were characterized by single cyst ，and 74cases were multiple or beaded cysts.Three pregnant women had hypertensive disorders in pregnancy.Nineteen cases were found with other fetal abnormalities.One hundred and two cases were followed up successfully ，in which 4cases had induced abortion due to severe deformity ，3cases delivered prematurely （1case died after birth and 2cases were healthy when followed up ），2fetuses were intrauterine death ，1case who had ventricular expansion was followed up to 2years old and developmental delay was found.The rest of 92cases were followed up for at least 24months after birth and all of them had a healthy neurological development.ConclusionPrenatal ultrasonography can accurately diagnose fetal subependymal cysts.Excluding other related abnormalitiesand malformations ，isolated subependymal cysts have a good short-term prognosis.KEY WORDSUltrasonography ；Fetus ；Subependymal cysts ；Prognosis室管膜下囊肿是指发生在尾状核头部与丘脑交界处、侧脑室前角旁的室管膜下区域即胚胎生发层基质的囊肿，因为此囊肿无上皮细胞覆盖，故为假性囊肿。
室管膜下囊肿既往在新生儿头颅超声有较多的研究，通常在出生后24h 内可检查到，因此，有文献［1］报道认为其为胎儿期发生，称之为先天性室管膜下囊肿，并认为其与宫内感染有关。
随着超声技术发展及分辨率的提升，胎儿时期超声发现此囊肿成为可能。
近来国外有少量病例报道［2-3］。
本研究旨在回顾性分析胎儿期室管膜下囊肿的声像图表现、发生时间、合并异常、产前和产后转归及临床预后。
资料与方法一、临床资料选取2010年1月至2012年8月我院产前超声检出的胎儿室管膜下囊肿135例，孕妇年龄19~42岁，平均26岁，均为单胎妊娠，首次检出时间为孕24～40周，平均孕31周。
其中45例胎儿行两次及以上（间隔2周以上）产前超声检查，31例胎儿行胎儿头颅MRI 检查，82例产后24h 内行新生儿头颅超声检查。
成功随访102例，其中存活新生儿共95例。
失访33例。
二、仪器与方法1.仪器：使用GE Voluson E 8和GE Voluson 730Expert 彩色多普勒超声诊断仪，经腹部二维凸阵及三维容积探头，频率分别为2.0～5.0MHz 及6.0～8.0MHz ；产后超声应用GE Voluson i ，二维凸阵探头及线阵探头，频率分别为2.0～5.0MHz 及12.0MHz ；胎儿头颅MRI 仪使用GE 1.5T 检查。
2.方法：所有胎儿均行系统的产前超声检查，包括胎儿结构观察及妊娠附属物的观察。
对胎儿室管膜下囊肿的病例，主要DOI:10.16245/ki.issn1008-6978.2015.06.023表1胎儿室管膜下囊肿合并胎儿异常及临床结局轻度脑室扩张室管膜下出血Ⅰ级胎儿生长受限脐血流及大脑中动脉异常透明隔腔消失、胼胝体发育不全、蛛网膜囊肿、Blake ’s Pouch 囊肿淋巴管水囊瘤Dandy-Walker 畸形胎儿水肿综合征63331111引产00001111胎死宫内00110000婴儿存活63220000采用胎儿头颅横切面及旁矢状切面（由二维或三维超声重建获得）观察胎儿侧脑室前角外侧。
分析所有病例声像图表现特点、发生时间、妊娠合并症及合并胎儿异常情况；胎儿颅内出血的分级采用新生儿颅内出血常用的分级法：Ⅰ级为室管膜下出血；Ⅱ级为脑室内出血但无脑室扩大；Ⅲ级为脑室内出血伴脑室扩大；Ⅳ级为脑室内出血伴脑实质出血。
3.观察项目：①观察行两次及以上（间隔2周以上）产前超声检查病例的囊肿大小变化；②将产后24h 内行新生儿头颅超声检查与产前超声检查对照；③将胎儿MRI 检查结果与超声结果对照；④随访病例的临床结局，存活新生儿出生后至2岁神经发育情况，评估主要采用Baylay 婴幼儿发育量表第2版。
结果一、胎儿室管膜下囊肿的声像特点胎儿头颅横切面时囊肿均位于侧脑室前角外侧或侧脑室前角与体部交界处的外侧；胎儿头颅旁矢状切面时可见位于尾状核头与丘脑交界的室管膜下区，囊肿壁薄，边界清。
其中单侧发生41例，占30%。
单发囊肿61例，多发或呈串珠样74例，囊肿3mm ×3mm ～23mm ×12mm 。
见图1～3。
箭头所示为胎儿颅脑横切面，位于左侧侧脑室前角旁的单发室管膜下囊肿，大小约3mm ×3mm图1胎儿单侧室管膜下囊肿箭头所示胎儿颅脑横切面，分别为左、右侧呈串珠样多发囊肿图2胎儿双侧室管膜下囊肿呈多发串珠样箭头所示为囊肿所在位置，位于丘脑与尾状核头部交界的室管膜下区图3胎儿大脑旁矢状切面显示多发串珠样的室管膜下囊肿二、胎儿室管膜下囊肿合并症3例（2.2%）孕妇合并妊娠期高血压疾病，均为轻度子痫前期；合并胎儿异常19例（14%），其中合并胎儿轻度脑室扩张6例，扩张程度为10～13mm ；合并室管膜下出血3例，均为颅内出血Ⅰ级；胎儿生长受限3例；合并脐血流及大脑中动脉血流异常3例；其他异常4例。
见表1。
三、室管膜下囊肿产前及产后转归45例孕妇行产前超声复查，囊肿消失3例，复查间隔平均孕4.6周，均为单发囊肿。
82例产后24h 内行新生儿头颅超声检查，4例囊肿消失，均为单发囊肿；5例产前超声诊断为单侧发生而产后超声诊断为双侧；余73例均与产前超声结果一致，大小均未见明显变化（图4）。
四、产前超声与产前胎儿MRI 结果对照31例行胎儿头颅MRI 检查者，与产前超声检查结果的位置、大小均符合（图5），符合率100%。
同时MRI 未发现超声漏诊其他脑部疾病。
五、临床结局失访33例，成功随访102例。
4例因合并严重畸形引产。
3例早产，其中1例孕27+周时发生早产，出生后死亡，余2例孕34+周后早产，随访至2岁均健康发育。
2例胎死宫内，其中1例为胎儿生长受限，1例为羊水过少且胎儿脐动脉舒张期血流缺失。
1例合并双侧脑室扩张13mm 者，随访至2岁智力发育迟缓。
余92例随访至出生后24个月，均健康发育。
讨论胎儿室管膜下囊肿罕有报道。
本研究旨在分析胎儿室管膜下囊肿的声像特征，并对比胎儿MRI 图像，以达到精确诊断的目的，同时通过产前、产后超声图像的对比，明确新生儿室管膜例妊娠结局合并异常例数A ：孕34+周胎儿声像图（箭头所示）；B ：出生后8h ，超声经新生儿颞囟声像图（箭头所示）图4产前与产后室管膜下囊肿的对比声像图A A ：超声大脑横切面；B ：胎儿头颅MRI 横切面图5孕34+周胎儿室管膜下囊肿影像学对比图下囊肿为胎儿期的延续。
