MRI诊断胎儿先天性肺囊腺瘤样畸形及肺隔离症的应用价值  

The value of MRI in prenatal diagnosis of congenital cystic adenomatoid malformation and bronchopulmonary sequestration

作　　者：林开武[1] 周作福[1] 施跃全[1] 李尔烜[1] 苏宇征[1] LIN Kaiwu;ZHOU Zuofu;SHI Yuequan;LI Erxuan;SU Yuzheng(Department of Radiology,Fujian Maternity and Child Health Hospital,Fuzhou 350001,P.R.China)

机构地区：[1]福建省妇幼保健院影像科,福建福州350001

出　　处：《医学影像学杂志》2020年第6期1056-1058,1062,共4页Journal of Medical Imaging

摘　　要：目的探讨MRI在诊断胎儿先天性肺囊腺瘤样畸形及肺隔离症的应用价值。方法收集我院2010年2月~2017年9月产前MRI诊断为先天性肺囊腺瘤样畸形(CCAM)的27例胎儿及诊断为支气管肺隔离症(BPS)的11例胎儿,出生后均行胸部低剂量CT增强复查及手术治疗,以病理结果为金标准,并与产前MRI检查结果进行对照,对胎儿CCAM及BPS的MRI特点进行回顾性分析。结果38例胎儿中,术后病理诊断为BPS 12例(肺内型9例、肺外型3例),CCAM 26例(大囊型16、微囊型10例),其中BPS产前MRI诊断正确10例,CCAM产前MRI诊断正确25例;其中1例微囊型的CCAM,产前MRI诊断为BPS,其中2例BPS产前MRI诊断为微囊型CCAM,所有病例均未合并胎儿水肿,7例出现心脏左偏(CCAM5例、BPS2例),4例心脏右偏(CCAM2例、BPS2例)。结论MRI对大囊型CCAM及显示供血动脉的BPS能够明确诊断,根据供血血管走行对于BPS和CCAM鉴别诊断有一定提示性,但是对于未显示供血血管的微囊型CCAM和BPS的鉴别诊断比较困难。Objective To investigate the value of magnetic resonance imaging(MRI)in prenatal diagnosis of congenital cystic adenomatoid malformation(CCAM)and bronchopulmonary sequestration(BPS).Methods The 27 fetuese with suspected CCAM and 11 suspected BPS were collected,diagnosed by prenatal MRI in our hospital from February 2010 to September 2017.All fetuses were subjected to low-dose chest CT enhanced reexamination and surgical treatment after birth.With pathological results as the gold standard,prenatal MRI findings had been compared with postnatal enhanced CT and surgicalpathology.MR imaging characteristics of fetal CCAM and BPS were analyzedretro spectively.Results After surgery,a total of 38 fetuses were diagnosed with BPS in 12 cases(9 of intrapulmonarytype and 3 of extrapulmonarytype)and CCAM in 26 cases(16 of macrocystic type,10 of microcystic type).10 BPS cases and 25 CCAM cases were correctly diagnosedby prenatal MRI.Among them,one case of microcystic CCAM was diagnosed as BPS by prenatal MRI;Two BPS cases were diagnosed as microcystic CCAM.None of the cases were complicated with fetal edema.There were 7 cases with left cardiac deviation(5 CCAM,2 BPS),4 cases with right cardiacd eviation(2 CCAM,2 BPS).Conclusion BPS with the feeding arteries and macrocystic CCAM can be definitively diagnosed by MRI.According to the feeding artery,there is some suggestion for the differential diagnosis of BPS and CCAM.However,the differential diagnosis of microcystic CCAM and BPS without the feeding artery is difficult.

关 键 词：支气管肺隔离症 肺囊腺瘤样畸形 磁共振成像 胎儿 

分 类 号：R714.53[医药卫生—妇产科学] R445.2[医药卫生—临床医学]