MRI诊断胎儿脊柱脊髓畸形及序列选择  

Selection of MR sequences in diagnosis of fetal spinal cord malformation

作　　者：梁艳山 张小安[1] 赵鑫[1] 栗河舟[2] LIANG Yanshan;ZHANG Xiaoan;ZHAO Xin;LI Hezhou(Department of Medical Imaging,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院医学影像科,河南郑州450052 [2]郑州大学第三附属医院超声科,河南郑州450052

出　　处：《中国医学影像技术》2020年第1期111-115,共5页Chinese Journal of Medical Imaging Technology

基　　金：河南省医学科技攻关计划项目(2017T02042)

摘　　要：目的探讨MRI诊断胎儿脊柱脊髓畸形的价值及序列选择。方法回顾性分析产前超声疑诊胎儿脊柱脊髓异常且48 h内接受MR针对性脊柱检查(Haste、Trufi和SWI)的30胎,分别与产后(生产或引产)6个月内随访结果(影像学、手术或尸检)对照,分析MRI与超声诊断符合率及MR针对不同病变的序列选择。结果7胎无畸形,15胎椎体畸形(裂椎、半椎体、分隔不全、骶尾椎发育不全),5胎脊髓低位,3胎脊柱裂、脊髓脊膜膨出,4胎脊柱、脊髓复合畸形。产前MRI诊断与随访结果完全一致;产前超声漏诊椎体畸形2胎,脊髓低位4胎,脊膜膨出、脊髓空洞及纵裂各1胎。Haste、Trufi序列可较好地显示脊柱、脊髓结构和畸形,而SWI能清晰显示椎体结构和畸形。结论MR Haste及Trufi序列显示胎儿脊髓及椎管内异常准确性较高,而SWI对显示椎体畸形有独特价值。Objective To explore the value and selection of MR sequences in diagnosis of fetal spinal cord and spinal deformity.Methods Data of 30 fetuses underwent prenatal ultrasound screening and history abnormal fetal spinal cord and 48 h adept MRI(Haste,Trufi and SWI)targeted examination about fetal spine were retrospectively analyzed,and compared with postpartum(production or induced labor)within 6 months of follow-up results(image,surgery or autopsy).The diagnosis coincidence rate of MRI and ultrasound,and MR sequence selection for different pathological changes were compared.Results Among 30 fetuses,7 were proved without deformity,15 were found with vertebral malformation(split vertebra,half vertebra,incomplete septa,sacrococcygeal vertebra dysplasia),5 with lower spinal cord,3 with spina bifida or myelomeningocele,4 with spinal cord complex malformation.Prenatal MRI diagnosis were completely consistent with follow-up results.Two fetuses of vertebral deformity,4 of low spinal cord and 1 of meningiocele,syenomyelia and longitudinal fissure were missed with prenatal ultrasound.MR Haste and Trufi sequences were satisfied in displaying the structure and deformity of fetal spinal cord,while SWI could clearly show fetal vertebral structure and deformity.Conclusion MR Haste and Trufi are accurate in displaying abnormalities in fetal spinal cord and spinal canal,while SWI has unique value in describing vertebral deformity.

关 键 词：胎儿 畸形 脊髓 磁共振成像 序列 

分 类 号：R714.5[医药卫生—妇产科学] R445.2[医药卫生—临床医学]