单次激发快速自旋回波厚层重水序列在胎儿肺部发育畸形诊断中的应用  

Application of SSFSE Thick Slab Sequence in Diagnosis of Fetal Pulmonary Developmental Malformation

作　　者：李鸿恩 吕培锋 李悦龙 曾益辉 张嫣[1] 杨朝湘[1] LI Hongen;LV Peifeng;LI Yuelong;ZENG Yihui;ZHANG Yan;YANG Chaoxiang(Department of Radiology,Guangdong Province Hospital for Women and Children Healthcare,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院放射科,广东广州511400

出　　处：《中国医学影像学杂志》2023年第10期1103-1108,共6页Chinese Journal of Medical Imaging

摘　　要：目的探讨单次激发快速自旋回波厚层重水(SSFSE Thick Slab)序列在胎儿肺部发育畸形诊断中的应用价值。资料与方法前瞻性收集2019年1月—2020年6月在广东省妇幼保健院经超声检查诊断或可疑胎儿肺部发育异常并行MRI的110例孕妇资料,采用胎儿常规快速扫描序列行单次激发快速自旋回波(SSFSE)、快速成像稳态采集(FIESTA)、快速反转恢复运动抑制(FIRM)、扩散加权成像(DWI)扫描,再行SSFSE Thick Slab序列扫描。将MRI诊断结果与(引)产后或病理随访结果进行比较,分析常规序列与SSFSE Thick Slab序列结合常规序列对胎儿肺部病变的诊断确定性。以病理为“金标准”,分析MRI对肺部病变的诊断效能。结果110个胎儿MRI肺部检查中,82个(引)产后或病理随访明确诊断,其中支气管肺隔离症(BPS)12例[MRI正确诊断11例,误诊为先天性肺气道畸形(CPAM)1例],CPAM 59例(MRI正确诊断58例,误诊为BPS1例),先天性肺过度膨胀4例(MRI正确诊断1例,误诊为CPAM 3例),支气管源性囊肿2例(MRI正确诊断2例),肺发育不全1例(MRI正确诊断1例),CPAM合并BPS 3例(MRI正确诊断3例),支气管源性囊肿合并先天性肺过度膨胀1例(MRI正确诊断1例)。8个随访证实儿童健康病例中(MRI诊断为CPAM 7例,BPS 1例)。常规序列与SSFSE Thick Slab序列结合常规序列对胎儿肺部诊断确定性分析:由胎儿常规序列(SSFSE、FIESTA、FIRM、DWI)诊断确定66例,不确定24例,不确定病例分别为BPS 3例,CPAM 19例,CPAM合并BPS 2例;由胎儿常规序列结合SSFSE Thick Slab序列诊断确定77例,不确定13例,不确定病例分别为BPS 2例,CPAM 10例,CPAM合并BPS 1例;两组比较,差异有统计学意义(χ^(2)=4.116,P=0.042)。MRI诊断胎儿肺部病变的敏感度为93.9%,特异度为0,准确度为85.6%,阳性预测值为90.1%,阴性预测值为0。结论SSFSE Thick Slab序列在胎儿肺部含水量高的疾病中表现为特征性高信号,结合胎儿常规序列能提高胎儿�Purpose To investigate the application value of single-shot fast spin-echo thick slab(SSFSE Thick Slab)in the diagnosis of fetal pulmonary developmental malformation.Materials and Methods The data of 110 pregnant women diagnosed by ultrasound or suspected fetal pulmonary dysplasia via MRI in Guangdong Maternal and Child Health Hospital from January 2019 to June 2020 were prospectively collected.Fetal routine rapid scan sequence single-shot fast spin-echo(SSFSE),fast imaging employing steady-state acquisition(FIESTA),fast inversion recovery motion insensitive(FIRM),diffusion weighted imaging(DWI)scanning was performed,followed by SSFSE Thick Slab sequence scanning.MRI diagnosis results were compared with(citation)postnatal or pathological follow-up results to analyze the diagnostic certainty of fetal lung lesions with conventional sequence and SSFSE Thick Slab sequence combined with conventional sequence.Taken pathology as the gold standard,the diagnostic efficacy of MRI in pulmonary lesions was further analyzed.Results Of the 110 fetal MRI lung examinations,82(citation)were confirmed by postpartum or pathological follow-up,among which 12 cases were bronchopulmonary sequederation(BPS)[11 cases were correctly diagnosed by MRI and 1 case was misdiagnosed as congenital pulmonary airway malformation(CPAM)],and there were 59 cases with CPAM(58 cases were correctly diagnosed by MRI and 1 case was misdiagnosed as BPS),and there were 4 cases with congenital hyperinflation of lung(1 case was diagnosed correctly by MRI and 3 cases were misdiagnosed as CPAM).Two cases were diagnosed correctly as bronchogenic cysts via MRI.One case was diagnosed correctly as pulmonary hypoplasia via MRI.Three cases were diagnosed correctly as CPAM combined with BPS via MRI.One case was diagnosed correctly as bronchogenic cyst with congenital hyperinflation of lung via MRI.Eight children were confirmed healthy children via follow-up,however,of all 8 cases,7 cases were misdiagnosed as CPAM and 1 case as BPS via MRI.The deterministic analysis of

关 键 词：先天性畸形 磁共振成像 扩散加权成像 单次激发快速自旋回波厚层重水序列 胎儿 肺部 

分 类 号：R445.2[医药卫生—影像医学与核医学] R715[医药卫生—诊断学]