胎儿侧脑室边缘不规则形态模式：一项描述性研究
研究识别出突起、凹陷、波浪状和混合型四种主要模式，不同形态与神经元迁移障碍、破坏性损伤等不同病因相关。
要点
- 侧脑室边缘不规则分为突起、凹陷、波浪状和混合型四种主要模式。
- 结节状突起与神经元迁移障碍相关，非结节状突起见于破坏性损伤。
- 楔形凹陷常与脑室周围静脉出血性梗死或脑裂畸形一致。
核心结论
- 区分侧脑室边缘不规则的形态模式可为描述胎儿脑异常及其病因推断提供框架。
- 不同形态构型可能代表发育性或破坏性病因，但因果关系尚需进一步研究。
研究设计与样本
- 通过神经超声和胎儿磁共振成像评估侧脑室边缘不规则的类型、位置及室管膜异常情况。
- 收集产前诊断的其他畸形、母体TORCH血清学、基因检测、尸检结果及出生后结局资料。
主要发现
- 66例胎儿中，30例（45.5%）进行了基因检测。
- 33例（50.0%）选择终止妊娠，28例（42.4%）活产，出生后神经发育随访时平均年龄为3.4±1.2岁。
- 结节状突起19例（28.8%），见于神经元迁移障碍如脑室周围结节状异位或结节性硬化症。
- 非结节状突起4例（6.1%），见于破坏性损伤如脑室内出血或宫内胎儿巨细胞病毒感染。
- 圆形凹陷7例（10.6%），见于穿通性脑囊肿；楔形凹陷15例（22.7%），常与脑室周围静脉出血性梗死或脑裂畸形一致。
关键数值与推荐
- 侧脑室边缘不规则四种主要模式：突起（结节状或非结节状）、凹陷（圆形或楔形）、波浪状和混合型。
- 结节状突起19/66（28.8%）与神经元迁移障碍相关。
- 非结节状突起4/66（6.1%）与破坏性损伤相关。
- 圆形凹陷7/66（10.6%）与穿通性脑囊肿相关。
- 楔形凹陷15/66（22.7%）与脑室周围静脉出血性梗死或脑裂畸形相关。
临床怎么用
- 产前发现侧脑室边缘不规则时，应根据突起、凹陷、波浪状及混合型形态进行系统分类。
- 结节状突起提示需排查神经元迁移障碍，如脑室周围结节状异位或结节性硬化症。
- 非结节状突起应关注破坏性病因，如脑室内出血或宫内巨细胞病毒感染。
- 楔形凹陷需考虑脑室周围静脉出血性梗死或脑裂畸形，并评估室管膜内衬异常。
局限性
- 回顾性研究设计可能引入选择偏倚。
- 仅45.5%的病例完成基因检测，遗传学信息不完整。
- 活产病例出生后随访平均年龄仅3.4±1.2岁，远期神经发育结局尚不明确。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
原文
OBJECTIVES: Alterations in the lateral ventricular borders have been documented in the prenatal diagnosis of certain fetal brain conditions. This study aimed to describe and classify the morphological patterns of lateral ventricular border irregularities (LVBI) and to discuss possible etiologies. METHODS: This multicenter retrospective study reviewed all cases of prenatally diagnosed LVBI at three centers between January 2014 and December 2022. Neurosonography and fetal magnetic resonance imaging were used to determine the type of LVBI, its location and the presence of other ependymal abnormalities. Data regarding other prenatally diagnosed malformations, maternal TORCH serology, genetic testing, autopsy findings and postnatal outcomes were collected. RESULTS: Sixty-six fetuses were included in the analysis. Genetic testing was performed in 30/66 (45.5%) cases. Termination of pregnancy was elected in 33/66 (50.0%) of cases, and 28/66 (42.4%) were liveborn (mean ± SD age at postnatal neurodevelopmental follow-up, 3.4 ± 1.2 years). Four main LVBI patterns were identified: protrusions (nodular or non-nodular), indentations (round or wedge-shaped), undulations and mixed. Nodular protrusions (19/66 (28.8%)) were observed with neuronal migration disorders (periventricular nodular heterotopia or tuberous sclerosis complex), whereas non-nodular protrusions (4/66 (6.1%)) were observed in cases of disruptive injury (intraventricular hemorrhage or intrauterine fetal cytomegalovirus infection). Round indentations (7/66 (10.6%)) were observed in the context of porencephalic cysts, whereas wedge indentations (15/66 (22.7%)) were typically consistent with either periventricular venous hemorrhagic infarction or cleft (schizencephaly) with an abnormal ependymal lining. Undulating or mixed patterns (21/66 (31.8%)) were often observed in association with other malformations of cortical development. CONCLUSIONS: Characterizing the pattern of LVBI can provide a framework for describing fetal brain anomalies and suggesting their etiologies. These morphological configurations may represent different developmental or disruptive etiologies, but causal relationships require further study. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
引用
- Hadi, Sorotzkin, Haddad, et al. Morphological patterns of fetal lateral ventricular border irregularities: descriptive study. Ultrasound Obstet Gynecol. 2026. PMID: 41987549. doi:10.1002/uog.70217
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。