Neonatal subependymal cysts detected by sonography: prevalence, sonographic findings, and clinical significance.
Neonatal subependymal cysts detected by sonography: prevalence, sonographic findings, and clinical significance.
复制标题
超声检查检测到的新生儿室管膜下囊肿：患病率、超声检查结果和临床意义。
DOI：
10.2214/ajr.162.4.8141023
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
K. Lui
中科院分区：
文献类型：
--
作者：
G. Larcos;S. Gruenewald;K. Lui
目的
新生儿头颅超音波偶尔可发现室管膜下囊肿。这些囊肿可能是由于各种病理性疾病，但他们也发生作为一个“孤立”的条件，没有明显的原因，在一些病人。由于随访时间有限、神经发育评价的非正式性质以及先前报告的患者异质性队列，因此难以评估这些病变的临床意义。因此，本研究的目的是提供更完整和更长的神经发育随访，并描述新生儿颅脑超声检查发现的孤立性室管膜下囊肿的患病率和超声特征。
材料和方法
在4 1/2年的时间里，在我们的机构获得了4000多张颅超声图。我们回顾性地确定了17例新生儿（59项研究）有孤立性室管膜下囊肿的超声证据。一个高分辨率的实时机械扇区换能器被用来获得的声像图。没有受试者有并发出血、梗死、感染或先天性异常的临床或超声证据。神经发育结果独立确定。特别是，出生时体重低于1500克的早产儿由多学科发育团队进行纵向评估。采用Griffith智力发展量表对9名受试者进行了智商测试。
结果
室管膜下囊肿多呈泪滴状，大小2-11 mm，位于尾状丘脑沟或沿着尾状核前方。大多数患有囊肿的受试者（n = 15）早产（平均胎龄，31周;范围，25-34周）。14例2-41个月（平均22个月，中位数21个月）婴儿的随访结果可用。14名受试者中有13名发育正常;一名因轻度畸形特征而转诊的足月婴儿出现轻度整体发育迟缓。在9名受试者中测定的校正年龄的总商数的平均值为111（范围为103-120;正常，> 83）。15名新生儿至少进行了两次颅脑超声检查。在7例患者中，系列检查显示囊肿已消退或尺寸缩小（平均在初始超声检查后23周）。在其他8例中，没有观察到囊肿大小的变化，但第一次和最后一次超声检查之间的平均间隔仅为14天。
结论
新生儿的头颅超声偶尔显示孤立的室管膜下囊肿，通常发生在早产儿。在大多数情况下，不会发生严重的神经发育并发症。许多囊肿在不同时期后消退。
OBJECTIVE
Cranial sonography in neonates occasionally shows subependymal cysts. These cysts may be due to a variety of pathologic disorders, but they also occur as an "isolated" condition without an obvious cause in some patients. Assessment of the clinical significance of these lesions has been difficult because of the limited duration of follow-up, the informal nature of neurodevelopmental evaluation, and the heterogeneous cohort of patients previously reported. Accordingly, the purposes of this study were to provide more complete and longer neurodevelopmental followup and to describe the prevalence and sonographic characteristics of isolated subependymal cysts detected on cranial sonograms in neonates.
MATERIALS AND METHODS
In a 4 1/2-year period, more than 4000 cranial sonograms were obtained at our institution. We retrospectively determined that 17 neonates (59 studies) had sonographic evidence of an isolated subependymal cyst. A high-resolution real-time mechanical sector transducer was used to obtain the sonograms. No subjects had clinical or sonographic evidence of intercurrent hemorrhage, infarct, infection, or congenital abnormalities. Neurodevelopmental outcome was independently determined. In particular, premature infants who weighed less than 1500 g at birth were longitudinally assessed by a multidisciplinary developmental team. A general quotient was derived in nine subjects by using the Griffith Mental Developmental Scales.
RESULTS
Subependymal cysts were often tear shaped, 2-11 mm in size, and located either at the caudothalamic groove or along the anterior aspect of the caudate nucleus. Most subjects (n = 15) who had the cysts were born prematurely (mean gestational age, 31 weeks; range, 25-34 weeks). Results of follow-up were available in 14 infants 2-41 months old (mean, 22 months; median, 21 months). Development was considered to be normal in 13 of the 14 subjects; one term infant referred because of mild dysmorphic features had a mild global delay. The general quotient for corrected age, determined in nine subjects, had a mean of 111 (range, 103-120; normal, > 83). Fifteen neonates had at least two cranial sonographic examinations. In seven patients, serial examinations showed that cysts had resolved or diminished in size (on average 23 weeks after the initial sonographic study). In the other eight, no change in the size of the cyst was observed, but the mean interval between the first and last sonograms was only 14 days.
CONCLUSION
Cranial sonograms of neonates occasionally show isolated subependymal cysts, usually in premature infants. In most cases, no serious neurodevelopmental complications occur. Many cysts resolve after a variable period.