胎儿三维磁共振成像技术的初步应用  

Preliminary application of three dimensional magnetic resonance imaging of fetus

作　　者：孙子燕[1] 夏黎明[1] 庞颖[1] 杨小红[2] 赵胜[2] 王承缘[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030 [2]湖北省妇幼保健院,武汉430070

出　　处：《放射学实践》2011年第9期996-999,共4页Radiologic Practice

摘　　要：目的：探讨三维磁共振成像（3D-MRI）技术在显示胎儿体表正常解剖和先天畸形方面的应用价值。方法：对40例18~37周的胎儿在超声检查后1~2d内行MRI检查,应用单次激发快速自旋回波序列（SSFSE）行胎儿轴面、矢状面和冠状面二维MRI（2D-MRI）,三维稳态进动快速成像（3D-FIESTA）序列MRI,均使用并行采集技术（ASSET）,在工作站对原始数据进行多平面重组（MPR）、容积重组（VR）和磁共振仿真内窥镜技术（MRVE）等三维图像后处理。将MRI和随访、尸检结果进行比较。结果：36例孕妇3D-MRI检查成功率为94.4%（34/36）,34例胎儿经随访和尸检证实46处畸形。胎儿体表先天畸形2D-MRI正确诊断37处,诊断符合率80.4%（37/46）;误诊1处,假阳性率为2.1%（1/46）;漏诊8处,漏诊率17.4%（8/46）。3D-MRI正确诊断43处,诊断符合率93.5%（43/46）;误诊1处,假阳性率2.1%（1/46）;漏诊2处,漏诊率为4.3%（2/46）。两种方法诊断胎儿体表先天畸形差异无统计学意义（χ2=2.40,P〉0.05）,但3D-MRI对于面部畸形如唇裂和其他复杂畸形如体蒂异常、骶尾部畸胎瘤、联体双胎等显示更直观清楚。结论：3D-MRI一次扫描可直观反映胎儿体表结构的表面特征、立体形态及相互间的位置关系,VR、MRVE对胎儿正常面部、外生殖器、脐带、肢体等的评价有较高价值,MPR可对兴趣区进行多角度观察。磁共振三维成像对显示胎儿正常体表结构和病变及产前咨询和围产期手术具有重要的临床价值。Objective：To investigate the clinical value of three dimensional magnetic resonance imaging（3D-MRI） in displaying the normal and abnormal body surface structures of the fetuses.Methods：40 fetuses（range,18~37 weeks） with congenital abnormalities underwent 2D-MRI axial、sagittal and coronal SSFSE T2WI examinations and 3D-MRI with three dimensional fast image employing steady-state acquisition（3D-FIESTA）.Volume rendering（VR） on a GE 1.5T superconducting MR scanner within 1～2 days after US conventional prenatal examinations.multiplanar reconstruction（MPR） magnetic resonance virtual endoscope（MRVE） were employed in image post-processing on a dedicated workstation.The MRI appearances of fetal malformations were compared with autopsy and follow-up results.Results：The achievement ratio was up to 94.4%（34/36）.＂one stop＂ 3D-FIESTA could clearly demonstrate the surface features of the fetus,such as the fetal face,genitalia,umbilical cord and extremity etc.The regions of interest could be viewed in various directions by using multi-planar mode 2D-MRI.In all of 37 body surface anomalies,the correct diagnostic rate was 80.4%,the false-positive rate was 2.1%,the missed-diagnostic rate was 17.4%.In 43 body surface anomalies diagnosed with 3D-MRI,the correct-diagnostic rate was 93.5%,the false-positive rate was 2.1%,the missed-diagnostic rate was 4.3%.There was no difference between 2D and 3D-MRI（χ2=2.40,P0.05）.But facial malformations such as cleft lip and other complicated malformations such as body stalk anomaly、sacrococcygeal teratoma、conjoined twins could be more clearly demonstrated by 3D-MRI.Conclusions：The 3D-MRI study of fetus is feasible and useful for displaying fetal anatomy and has a wide clinical applications,for antepartum console and planning of fetal surgery.

关 键 词：胎儿 成像 三维 磁共振成像 产前诊断 

分 类 号：R714.53[医药卫生—妇产科学] R445.2[医药卫生—临床医学]