MRI诊断胎儿腹裂1例并文献复习  

MRI diagnosis of fetal gastroschisis:a case report and literature review

作　　者：胡蓉 丁志勇 邱树芬 赵晓 HU Rong;DING Zhiyong;QIU Shufen;ZHAO Xiao(Department of Medical Imaging,Nanyuan of Qujing Maternal and Child Health Hospital,Yunnan Province,Qujing655000,China)

机构地区：[1]云南省曲靖市妇幼保健院南苑医学影像科,云南曲靖655000

出　　处：《中国当代医药》2023年第14期157-160,共4页China Modern Medicine

摘　　要：胎儿腹裂是一种罕见的先天畸形,发病机制尚不明确,为脐旁腹壁肌层缺损,腹腔内容物外翻至羊膜腔,缺损大多位于脐部右侧,左侧较少见。如果能在孕期及时对胎儿腹裂作出详细、准确的诊断,对胎儿的预后及结局会具有指导性的作用。胎儿MRI是目前研究日趋成熟的影像技术之一,具有较高的软组织分辨率,可以清晰地显示胎儿腹壁缺损的位置、大小,明确外翻脏器的组成部分,评估外翻肠管损伤的程度;利用三维容积成像能够计算外翻脏器体积与腹腔容积的体积比。其是超声检查的重要补充手段,特别是针对复杂性胎儿腹裂,往往较超声能获得更多的信息。现对2022年7月云南省曲靖市妇幼保健院收治的1例妊娠晚期合并胎儿腹裂患者的临床信息及影像资料进行回顾性分析,并对相关文献进行复习,以提高影像科及临床医生对胎儿腹裂的认识,掌握其MRI影像诊断的要点及鉴别诊断,指导产科医师采取合理的分娩方式,为儿外科提供手术预设计,改善患儿的预后,降低腹裂患儿的病死率。Fetal gastroschisis is a rare congenital malformation,the pathogenesis of which is still unclear.It is a paraumbilical abdominal wall muscle layer defect,with the contents of the abdominal cavity everted into the amniotic cavity.Most of the defects are located on the right side of the umbilical,and the left side is rare.If the detailed and accurate diagnosis of fetal gastroschisis can be made in time during pregnancy,it will have a guiding role in the prognosis and outcome of the fetus.Fetal MRI is one of the imaging technologies that are becoming more and more mature at present.It has a high soft tissue resolution,can clearly show the location and size of fetal abdominal wall defects,identify the components of everted organs,evaluate the extent of everted bowel damage,and can calculate the volume ratio of everted organs to abdominal cavity volume using three-dimensional volume imaging.It is an important complementary means of ultrasonic examination,especially for complex fetal gastroschisis,more information can often be obtained than ultrasound.The clinical information and imaging data of a case of late pregnancy with fetal gastroschisis admitted to Qujing Maternal and Child Health Hospital in July 2022 in Yunnan Province are reviewed,and the relevant literature is reviewed to improve the understanding of the department of imaging and clinicians on fetal gastroschisis,master the key points of MRI imaging diagnosis and differential diagnosis,guide obstetricians to take reasonable delivery methods,and provide surgical pre design for pediatric surgery,improve the prognosis of children,reduce the mortality of children with gastroschisis.

关 键 词：胎儿腹裂 产前诊断 MRI 彩超 

分 类 号：R445.2[医药卫生—影像医学与核医学]