MRI对选择性激光电凝术后双胎输血综合征胎儿脑部病变诊断优势  

The advantage by MRI of brain lesions after fetoscopic selective laser coagulation for twin-twin transfusion syndrome

作　　者：刘祎[1] 宋亭[1] 陈展航[1] 唐文艳[1] 陈永露[1] 陈柳冰 

机构地区：[1]广州医科大学附属第三医院放射科,广东广州515150

出　　处：《实用放射学杂志》2018年第1期1-4,共4页Journal of Practical Radiology

基　　金：2015年度广州医科大学附属第三医院青年项目（2015Y09）;2015年广州市荔湾区科技计划项目（20121217096）.

摘　　要：目的探讨MRI与超声相比，对选择性激光电凝术（SLCPV）治疗后的双胎输血综合征（TTTS）胎儿脑部病变诊断优势。方法收集经SLCPV治疗后的TTTS胎儿。所有胎儿都在术后1～5d行MRI检查，之后经29～32周MRI随访，并间断接受超声检查直至分娩。结果首次MRI筛查后，最终收集到25例符合条件的孕妇，其中6例孕妇只有1个胎儿存活（A组，6例胎儿），19例孕妇有2个胎儿存活（B组，38例胎儿）。A组中有2例、B组中有3例在术后发现侧脑室内积血。B组中有2例胎儿脑实质出现急性缺血梗死灶。B组中1例胎儿术后脑实质萎缩，之后选择终止妊娠。结论MRI对于SLCPV后的胎儿神经系统病变，有着早期发现、早期诊断的优势。Objective To demonstrate that MRI is more advantageous than ultrasound in the detection of ischemic cerebral lesions precisely in twin-twin transfusion syndrome（TTTS）fetus following fetoscopic selective laser coagulation（SLCPV）.Methods The fetus with TTTS treated by SLCPV were collected.All fetuses underwent brain MRI within 1-5 days after the procedure and a follow-up MRI at 29-32 weeks＇gestation.All fetuses also had frequent ultrasound evaluation until delivery.Results Twenty-five pregnancies with TTTS were included in the study.Six pregnancies resulted in survival of only one twin after the procedure（Group A）,while the other 19 pregnancies resulted in the survival of both twins（Group B）,as assessed at the time of initial MRI.Two fetus in Group A and three in Group B had evidence of bleeding in lateral ventricle.Two fetus in Group B had actue brain ischemia.One fetus in Group B had appeared brain atrophy and choosed to terminate pregnancy.Conclusion MRI can make a clearer diagnosis of cerebral damage of TTTS fetus in a short period after SLCPV.

关 键 词：双胎输血综合征 选择性激光电凝术 磁共振成像 超声 

分 类 号：R714.43[医药卫生—妇产科学] R445.2[医药卫生—临床医学]