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胎儿侧脑室扩张的判断标准
在妊娠中晚期，侧脑室宽度一般比较稳定，大约6～8mm。目前判断脑室扩张的标准是测量侧脑室三角区横径，妊娠任何时期当三角区横径10mm而无其他畸形时称为单纯性侧脑室扩大。
研究发现，胎儿侧脑室宽度＞12mm时，其合并其他畸形的概率较高，专家以12mm为界限，用轻度（10～12mm）、中度（13～15mm）和重度（＞15mm）进行分类。
胎儿侧脑室扩张的原因
各种原因引起的局部脑组织发育不良甚至缺失、脑脊液循环受阻积聚于脑室或脑脊液产生过多，均可引起侧脑室扩张。分为单纯性扩张和病理性扩张
1、脑实质的发育不良：脑发育不良或萎缩的情况可能由宫内缺氧、代谢异常、感染或脑梗死引起，与其相关的侧脑室扩张多为非对称性的。临床常见胎儿脑室旁白质软化症、胼胝体缺如、脑皮质发育异常、后颅窝和/或中脑发育畸形等。
感染：弓形虫是最常见的引起胎儿侧脑室扩张的病原体，巨细胞病毒感染亦可引起脑发育不良或脑萎缩而导致脑室扩张。
2、脑脊液循环受阻：中脑导水管狭窄、Chiaris畸形、颅内出血、染色体或遗传学异常。
3、脑脊液产生过多：脉络丛乳头状瘤可引起脑脊液过量产生，从而导致脑室扩张和进展性脑积水，但非常罕见。有时也可发现脉络丛形成囊肿，常易合并其他颅内颅外异常。
胎儿侧脑室扩张的预后
1、轻度单纯性脑室扩张，有自行恢复的可能，随着妊娠月份的增大或胎儿的出生，如果增宽的侧脑室减小或者保持不变，预后较好。但约有20%的轻度侧脑室扩张胎儿由于合并染色体异常和其他颅内外异常而出现智力或发育障碍。
2、中、重度侧脑室扩张胎儿合并其他异常甚至染色体异常的风险较轻度者显著增高。重度侧脑室扩张者更加明显，合并其他异常的比例达58%~65%，仅有5%~8%的病例存活并具备正常的神经系统预后。
3、单侧不对称性的侧脑室增宽，相对于双侧侧脑室增宽，预后更好。
◆注：原文来自网络，版权归原作者所有。
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