MR快速扫描技术在胎儿先天性膈疝中的应用  

Application of MR fast scanning techniques in fetal congenital diaphragmatic hernia

作　　者：李晓会[1] 孙泓泓[1] 晋瑞[1] 白芝兰[1] 庄贵华[2] 吴晓琴[1] 唐亚萍[1] 

机构地区：[1]西安交通大学第二附属医院影像科,陕西西安710004 [2]西安交通大学公共卫生学院

出　　处：《实用放射学杂志》2014年第11期1910-1912,共3页Journal of Practical Radiology

摘　　要：目的探讨MR快速扫描技术在胎儿先天性膈疝（CDH）中的影像诊断价值。方法对12例孕20周以上超声诊断或怀疑CDH的胎儿行MR检查。采用快速扫描序列：半傅里叶采集单次激发快速自旋回波序列（HASTE）、真稳态进动快速成像序列（True FISP）、超快速FLASH（Turbo FLASH）T1WI序列。重点对胎儿的头颅和躯干行横断位、冠状位、矢状位扫描，将产前MRI表现与新生儿手术病例或引产后尸体解剖结果对照分析。结果12例胎儿CDH中9例为左侧膈疝，2例为右侧膈疝，1例食管裂孔疝；其中2例合并其他先天性畸形。MRI主要表现：HASTE及True FISP序列可见部分或大量肠管及胎胃跨过膈肌疝入胸腔，疝入的胎胃为高信号，肠管呈散在的高信号，并可见肠型，仅肺尖处见肺组织，心脏向对侧移位；Turbo FLASH T1WI序列获得T1图像，该序列肠管中胎粪为特征性高信号，可清晰显示结肠和部分小肠轮廓。全部病例的MRI产前诊断结果与手术（10例）或尸检（2例）结果一致。结论MR快速扫描技术能清晰显示胎儿CDH，多序列扫描图像清晰、全方位显示疝入胸腔的组织结构及周围的解剖关系，具有一定的临床诊断价值。Objective To investigate the diagnostic value of MR fast scanning techniques in fetal congenital diaphragmatic hernia. Methods 12 cases diagnosed or suspected fetal congenital diaphragmatic hernia by ultrasound with gestational age （〉 20 weeks） were underwent MR examination. The fast scan sequences were as follows： Half-Fourier acquisition single-shot fast spinecho sequence（ HASTE）, True fast imaging steady-state precession sequence （True FISP）, Turbo FLASH T1WI sequence. The axial, coronal and sagittal scanning were focused on fetal head and body. The results of prenatal MR examination was compared with neonatal surgical findings or autopsy results after inducing labor. Results All of 12 cases, 9 cases were left diaphragmatic hernia, 2 cases were right diaphragmatic hernia and 1 case was hiatal hernia. 2 cases of them were complicated with other congenital malformations. The features of MRI were as follows： Some portions of bowels and stomach crossed into the thorax were visible in the HASTE and TRUE FISP sequence. The herniated stomach and bowels showed high or scattered high signals. The intestinal types were visible as well. The lung tissue intruded at the apex of the lung and the heart deviated to the opposite side were demonstrated. T1 weighted images obtained from ultra-fast FLASH （Turbo FLASH） T1 WI sequence showed characteristic high signals in the meconium, which delineated clearly the shape of the colon and small intestine. The prenatal MRI results of all cases were consistent with surgical （10 cases） and autopsy （2 cases） findings. Conclusion MR fast scanning techniques can clearly show fetal congenital diaphragmatic hernia. Multiple sequences scanning can comprehensively map the organizational structure and anatomical relationship of fetal congenital diaphragmatic hernia with the surrounding tissues. MR fast scanning techniques play an important role in the diagnosis of fetal congenital diaphragmatic hernia.

关 键 词：先天性膈疝 磁共振成像 快速扫描 

分 类 号：R655.6[医药卫生—外科学] R445.2[医药卫生—临床医学]