胎儿肺隔离症超声与磁共振诊断应用分析  

The value of ultrasound and MRI in the diagnosis of pulmonary sequestration

作　　者：夏薇[1] 夏风[1] 刘芳[1] 兰为顺[1] 余旭东[1] 欧阳伟[1] 苏永学 李琳[1] 袁先宏[1] 杨文忠[1] 陈欣林[2] 

机构地区：[1]湖北省妇幼保健院医学影像科,武汉430070 [2]湖北省妇幼保健院超声诊断科,武汉430070

出　　处：《中华医学超声杂志（电子版）》2015年第5期379-382,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的总结胎儿肺隔离症超声及磁共振诊断价值。方法对湖北省妇幼保健院2013年7月至2015年2月产前超声怀疑胎儿肺隔离症的7例孕妇于超声检查后24 h内进行胎儿磁共振检查,采用半傅里叶采集单次激发快速自旋回波序列(HASTE)及真实稳态进动快速成像序列(True FISP)行胎儿胸部冠状面、矢状面及横轴面扫描。与出生后胸部增强CT或病理检查结果对照,总结胎儿肺隔离症产前超声及MRI影像特征。结果 7例肺隔离症胎儿病变位于左侧5例,右侧2例,其中1例合并先天性肺囊腺瘤样畸形。肺隔离症超声表现为稍高至高回声团块,内部回声均匀。经彩色多普勒检查可明确供血动脉。肺隔离症MRI表现为肺内T2WI上团块状高信号影,其信号高于周围正常肺组织,边界较清晰,可见体循环来源供血动脉,在T2WI上呈线条状低信号影。与产后病理检查或胸部增强CT检查结果对照,产前超声及MRI检查均可对7例肺隔离症病灶准确定位,但各有2例供血动脉判断错误。结论产前超声是检出胎儿肺隔离症的首选方法,而MRI可直接显示胎儿隔离肺组织的位置及形态,确定供血动脉,对于胎儿肺隔离症的诊断及预后有较高价值,可作为肺部异常胎儿产前超声检查的重要补充方法。Objective To investigate the diagnostic value of ultrasound and MRI in fetal bronchopulmonary sequestration （BPS）. Methods The 7 pregnant women with suspected fetal BPS were examined with a 1.5 T MR unit within 24 h after prenatal ultrasound in Hubei Maternal and Children＇s Hospital during July 2013 to February 2015. The imaging protocol included half-fourier acquisition single shot turbo SE （HASTE）, true fast imaging with steady state precession （True FISP） in axial, frontal and sagittal planes relative to the fetal thorax. Prenatal MR/findings have been compared with postnatal enhanced computed tomography or biopsy. Results The locations of BPS were in left side in 5 cases and in right side in 2 cases. One case was complicated with congenital cystic adenomatoid malformation （CCAM） of lung. Ultrasound showed the intrathoracic mass as a hyperechoic lesion and the feeding artery could be found by Doppler ultrasonography. T2WI could reveal not only the hyperintense lesions with clear boundary, but also the hypointense feeding artery originating from systemic circulation. Compared with pathological examination or enhanced CT, both of the ultrasound and the MRI could locate the lesions; however 2 feeding arteries were misjudged. Conclusions Prenatal ultrasound is the first-choice diagnostic modality for BPS. MRI can demonstrate the location, morphology and the feeding arteries of the fetal BPS, and also estimate the volume of normal lungs, which could be an important supplement to prenatal ultrasound in prenatal diagnosis and prognostic prediction of BPS.

关 键 词：超声检查 产前 磁共振成像 胎儿 肺 肺隔离症 

分 类 号：R445[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]