胎儿神经管缺陷畸形的MRI诊断  

Diagnosis of fetal neural tube defects by MRI

作　　者：董素贞 朱铭[1] 钟玉敏[1] 张弘[1] 潘慧红 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心影像诊断中心,200127

出　　处：《中华放射学杂志》2010年第4期350-353,共4页Chinese Journal of Radiology

基　　金：基金项目：上海市卫生局青年科研项目（2008y116）;上海高校选拔培养优秀青年教师科研专项基金资助项目（jdy08062）

摘　　要：目的探讨MRI在胎儿神经管缺陷畸形诊断中的应用价值。方法回顾性分析行MR检查的629例异常胎儿中10例神经管缺陷畸形胎儿的MRI资料。10例孕妇产前超声检查后24—48h内行MR检查，采用2D快速平衡稳态采集序列、单次激发FSE序列以及快速反转恢复运动抑制序列，行胎儿颅脑、胸、腹部常规及颅脑、脊柱重点冠状面、矢状面及横断面扫描，将产前MRI、超声表现与出生后脊髓MRI（3例）、引产后尸体外观检查或尸体解剖结果（7例）对照。结果9例为单胎，1例为双胎之一。随访结果与产前MRI诊断完全一致，产前超声漏诊1例、误诊2例。10例胎儿中无脑畸形1例，露脑畸形1例，羊膜带综合征所致脑膜脑膨出1例，脑膜膨出1例，胸段脊髓脊膜膨出1例，腰段脊柱裂1例，骶尾部脊髓脊膜膨出2例，骶尾部巨大囊状脊膜膨出1例，骶尾部脊柱裂1例。结论MRI在胎儿神经管缺陷畸形诊断方面具有较高的应用价值，能准确鉴别膨出内容物、定位脊髓病变位置。Objective To explore the diagnostic value of MRI on fetal neural tube defects. Methods Ten pregnant women,aged from 25 to 35 years （ average 28 years） and with gestation from 20--39 weeks （average 33 weeks） were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound （US） studies. The imaging protocol included fast-imaging employing steady-state acquisition, single-shot FSE and T1 -weighted fast inversion recovery motion insensitive sequences in the axial, frontal, and sagittal planes relative to the fetal brain, thorax, abdomen, and spines. Prenatal US and MRI findings were compared with postnatal MRI diagnoses （3 fetuses） or autopsy （7 fetuses）. Results Ten pregnant women （9 with a single fetus and 1 with twin fetuses ） were examined. For all cases, the diagnoses established by MRI were correct when compared with postnatal diagnosis or autopsy. In 7 cases, US and MRI findings were in complete agreement with postnatal diagnoses. US missed the diagnosis in 1 case and misdiagnosed in 2 cases. Ten neural tube defects in this study included anencephaly （ 1 case）, exencephaly （1 case）, meningoencephalocele associated with amniotic band sequence （1 case）, meningocele （1 case）, thoracic myelomeningocele （1 case）, lumbar spinal bifida （1 case）, sacroiliac myelomeningocele （2 cases）, sacroiliac large cystic spinal meningocele （1 case ）, sacroiliac spinal bifida （1 case ）. Conclusions Prenatal MRI is effective in the assessment of fetal neural tube defects. It can exactly discriminate herniated contents and locate the spinal lesion level.

关 键 词：胎儿 神经管缺损 磁共振成像 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学]