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首页> 外文期刊>Ultrasound >Diagnosis of grey matter heterotopia on cerebral ultrasound in a newborn: lessons from a case report for daily clinical practice
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Diagnosis of grey matter heterotopia on cerebral ultrasound in a newborn: lessons from a case report for daily clinical practice

机译：新生儿脑超声中灰质异位症的诊断：每日临床实践病例报告中的教训

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摘要

Grey matter heterotopias result from premature arrest of neuronal migration from the germinal matrix in the lateral ventricularnwall to the developing cortex. To date, heterotopias have been exclusively diagnosed on magnetic resonance imaging (MRI).nWe present a case of heterotopia primarily detected with transfontanellar cranial ultrasonography (CUS) and review thenliterature for sonographic signs to suggest the presence of this pathological entity. Transfontanellar CUS evaluation of anpreterm twin revealed a prominent rectangular-shaped left lateral ventricle. Subsequent angled views identified an abnormallynincreased echogenicity within the ipsilateral cortex. MRI confirmed subependymal and possibly subcortical heterotopia. Anliterature review using the search words ‘grey matter heterotopia’ was undertaken and further refined for specificninformation related to imaging criteria on MRI or sonography. Neuroradiologists classify heterotopias on MRI by location andnappearance into three types: subependymal, subcortical and band types. Signs of subependymal heterotopia on CUSninclude ventricular wall irregularity, hyperechoic periventricular band and isolated hyperechoic periventricular nodulesnprotruding into the ventricle. They are rarely associated with cortical lesions. CUS signs of subcortical heterotopia includenabnormal hyperechoic regions in the white matter. Our sonographic imaging revealed an irregular shape of the leftnventricle suggestive of subependymal heterotopia. Other abnormalities described with subependymal heterotopia were notnfound. A hyperechoic structure in the left cortical region next to the affected lateral ventricle could represent enfoldedncortex as is seen in subcortical heterotopia. We propose an extended search for cerebral lesions outside the usual field ofnview (i.e. white matter and cortex) using angled coronal and parasagittal CUS views to display frontal, occipital and lateralncortices as optimally as can be achieved whenever an angular or irregular lateral ventricle shape is encountered. Thendifferential diagnoses including haemorrhagic, ischaemic and structural parenchymal lesions should be extended to includengrey matter heterotopia.
机译：灰质异位症是由于神经元从侧脑室壁生发基质向发育皮层的迁移过早停止所致。迄今为止，异位症仅在磁共振成像（MRI）上诊断出来。n我们介绍了一例主要通过trans门颅颅超声检查（CUS）检测到的异位症病例，然后复习了超声检查的超声征象，以表明该病理实体的存在。 Transfontanellar CUS对早产双胞胎的评估显示出一个突出的矩形左心室。随后的倾斜视图表明同侧皮层内的回声异常增加。 MRI证实了表皮下和皮层下异位。进行了文献检索，使用搜索词“灰质异质性”，并进一步完善了与MRI或超声检查的影像学标准有关的特定信息。神经放射科医生将MRI上的异位症按位置和外观分为三类：表皮下，皮层下和条带类型。 CUSn的室管膜下异位症的迹象包括心室壁不规则，心室周围高回声带和突出到心室的孤立的高回声室周围结节。它们很少与皮质病变相关。皮质下异位症的CUS征象包括白质中的异常高回声区。我们的超声检查显示左室形状不规则，提示室管膜下异位症。没有发现与表皮下异位症有关的其他异常。如在皮层下异位症中所见，左侧皮层区域中靠近受影响的侧脑室的高回声结构可能代表了皮层包裹。我们建议使用倾斜的冠状和矢状CUS视线扩大对通常视野（即白质和皮质）视野以外的脑部病变的显示，以最佳地显示额叶，枕叶和外侧皮质，这在遇到角形或不规则的侧脑室形状时可以最佳地实现。 。然后应将包括出血性，缺血性和实质性实质性病变在内的鉴别诊断扩大到包括灰质异位症。

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