超声联合磁共振成像对胎儿脑皮质发育异常的诊断价值  

Diagnostic value of fetal cerebral cortical dysplasia by ultrasound combined with MRI

作　　者：汪雪娟 苗立友[1] 吴卓遥 Wang Xuejuan;Miao Liyou;Wu Zhuoyao(Department of Ultrasound,Women′s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210011,China;Department of Radiology,Women′s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210011,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)超声科,210011 [2]南京医科大学附属妇产医院(南京市妇幼保健院)放射科,210011

出　　处：《中华诊断学电子杂志》2020年第1期23-27,共5页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的探讨超声联合磁共振成像(MRI)检查评估胎儿脑皮质发育异常(MCD)的临床诊断价值。方法选取2015年8月至2019年11月在南京医科大学附属妇产医院超声科检查提示胎儿颅脑发育异常后行MRI检查的胎儿为研究对象,共207例,回顾性分析胎儿的影像资料特点,并对超声漏诊的原因进行分析。结果207例胎儿中有11例诊断为MCD。产前超声提示MCD的有9例,其中半侧巨脑症2例,多小脑回1例,无脑回畸形1例,小头畸形3例,脑裂2例,后均经MRI检查证实;产前超声未提示MCD类疾病的有2例,均因侧脑室增宽行MRI,诊断为室管膜下结节性硬化。同时发生两种不同种类MCD的胎儿有2例,1例为半侧巨脑畸形的胎儿,MRI检查增加了右顶叶脑裂畸形的诊断;另1例是无脑回畸形的胎儿,MRI检查增加了灰质异位的诊断。结论超声是发现胎儿MCD疾病的重要检查手段,MRI可以进一步证实,并且是超声检查手段以外的重要补充,超声联合MRI对胎儿MCD疾病有重大的诊断价值。Objective To explore the value of ultrasonography combined with magnetic resonance imaging(MRI)in the clinical diagnosis of fetal cerebral cortex development malformation(MCD).Methods Retrospectively analyzing the MRI findings of 207 fetuses with brain dysplasia indicated by ultrasonography in Women′s Hospital of Nanjing Medical University from August 2015 to November 2019,and analyzing the causes of missed diagnosis of ultrasonography.Results In 207 fetuses,11 cases were diagnosed with MCD.Nine cases of MCD were indicated by ultrasonography and then confirmed by MRI,including 2 cases of hemimegyria,1 case of polymicrogyria(PMG),1 case of anencephaly,3 cases of microcephaly and 2 cases of fissures.Two cases of MCD were not detected by prenatal ultrasonography,both of which were diagnosed as tuberous sclerosis under the test-tube membrane by MRI due to lateral ventriculomegaly.There were 2 cases with two concurrent MCD,1 case of hemimegalencephaly,and MRI increased the diagnosis of right parietal lobe fissure.Another case of anencephaly,and MRI increased the diagnosis of gray matter ectopic.Conclusions Ultrasonography is an important means to detect fetal MCD.MRI can further confirm the results of ultrasonography and it is an important supplement to ultrasonography.Ultrasonography combined with MRI is of great value in the diagnosis of fetal MCD.

关 键 词：大脑皮质发育异常 超声检查 产前 磁共振成像 胎儿 

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