胎儿多囊肾的磁共振产前诊断  

Polycystic kidney disease., appearance on fetal MRI

作　　者：邵剑波[1] 马慧静[1] 涂燕君[1] 

机构地区：[1]武汉市儿童医院CT＆MRI影像科,430016

出　　处：《临床肾脏病杂志》2011年第11期495-497,共3页Journal Of Clinical Nephrology

摘　　要：目的探讨胎儿多囊肾（PKD）的产前磁共振（MRI）表现及其诊断价值。方法对14例经超声和病理证实为胎儿多囊肾的MRI资料进行回顾性分析。结果ADPKD1例：双肾体积增大，T2WI见散在多发小囊状信号增高影，皮髓质分界不清，羊水量正常，膀胱可见充盈；ARPKD13例：①13例双肾体积明显均匀增大。②T2WI上，7例双肾信号呈中等以上增高，均匀一致；9例双肾皮髓质内见弥漫性针尖大小信号增高的囊泡影，呈放射状排列，笔者称为“苦瓜样”改变。③羊水无法显示8例，羊水极少5例。④10例未见膀胱显示。⑤合并9种畸形，其中前脑无裂畸形1例，脑积水3例，Dandy-Walker综合症3例，枕部脑膜膨出2例，颅内出血并孔洞脑1例，肺发育不良6例，多发性肝囊肿1例，唇裂1例，MeckebGruber综合征1例。结论PKD的MRI产前表现具有特异性，不受羊水量与胎儿体位的影响，可作为产前超声检查的重要补充手段，可提高其合并畸形的检出率。Objective To investigate the MRI findings and the value in the diagnosis of the fetal bilateral polycystic disease （PKD）. Methods MRI findings in 14 cases of fetal bilateral PKD con- firmed by ultrasound and pathology were retrospectively analyzed. Results （1） All cases had significant increases in volume of bilateral kidney with normal renal shape; （2） In one case of ADPKD there was increased signal on T2WI in vesicles of shadow of both kidneys; （3） In 9 cases of ARPKD, there were diffuse pinpoint-size hyperintense cystic changes in cortico-medullary region of both kidneys with radiated arrangement, so called ＂Karela-like＂ sign; （4） In 8 cases the amniotic fluid could not be shown, and in the rest 5 cases only very little amniotic fluid could be observed; （5） In 10 cases the u- rinary bladder was not shown; （6） There were 9 types of complicated malformations： holoprosenceph- aly （1 case）, hydrocephalus （3 cases）, Dandy-Walker syndrome （3 cases）, occipital meningocele （2 cases）, intracranial hemorrhage and porencephaly （1 case）, pulmonary hypoplasia （6 cases）, multiple liver cysts （1 case）, cleft lip （1 case）, Meckel-Gruber syndrome （1 case）. Conclusions MRI findings of patients with PKD have the specificity and are not affected by the volume of amniotic fluid. They can be used as an important complementary diagnostic modality for prenatal ultrasound examination to increase the detection rate of the combined abnormalities.

关 键 词：胎儿 多囊.肾疾病 磁共振成像 产前诊断 

分 类 号：R714.5[医药卫生—妇产科学]