MRI联合超声检查诊断胎儿多囊性发育不良肾  

MRI Combined with Ultrasonography in the Diagnosis of Fetal Multicystic Dysplastic Kidney

作　　者：杨琪 兰为顺[1] 陈欣林[2] 向雷 杨文忠[1] 刘芳[1] 万亚平 洪阳 YANG Qi;LAN Weishun;CHEN Xinlin;XIANG Lei;YANG Wenzhong;LIU Fang;WAN Yaping;HONG Yang(Department of Medical Imaging,Hubei Maternal and Children’s Hospital,Wuhan 430070,China;不详)

机构地区：[1]湖北省妇幼保健院医学影像科,湖北武汉430070 [2]湖北省妇幼保健院超声诊断科,湖北武汉430070

出　　处：《中国医学影像学杂志》2024年第5期486-489,491,共5页Chinese Journal of Medical Imaging

基　　金：湖北省卫生健康委员会联合基金项目(WJ2019H294)。

摘　　要：目的探讨产前MRI作为胎儿多囊性发育不良肾(MCDK)补充性影像学检查的可行性,提高本病的诊断水平。资料与方法回顾性分析2018年1月—2021年12月在湖北省妇幼保健院产前MRI诊断为MCDK的104例胎儿,将MRI检查结果与尸检或出生后手术及超声与MRI结果进行对照,并对比MRI与超声检查的诊断准确度,分析MRI联合超声诊断MCDK的优势。结果104例经MRI诊断为MCDK的胎儿中,102例通过因畸形引产的胎儿标本或出生后随访证实为MCDK,2例误诊。4例羊水明显减少或无羊水。102例于产后随访或引产后尸检证实患者中,58例(56.9%)超声诊断为MCDK,40例(39.1%)超声发现肾脏呈多囊样改变,但未明确诊断MCDK,4例(3.9%)超声误诊为其他疾病(1例成人型多囊肾,1例多发肾囊肿,2例肾缺如)。结论产前MRI较产前超声诊断胎儿MCDK时可获得更多诊断信息,特别是在羊水少、孕妇肥胖等因素影响超声图像质量的情况下,MRI可作为产前超声诊断胎儿MCDK的可靠补充检查.Purpose To explore the feasibility of prenatal MRI as a supplementary imaging examination of fetal multicystic dysplastic kidney(MCDK),and to improve the accuracy of imaging diagnosis.Materials and Methods The MR images of 104 fetuses diagnosed as MCDK by prenatal fetal MRI in Hubei Maternal and Children’s Hospital from January 2018 to December 2021 were retrospectively analyzed.The results of fetal MRI were compared with those of autopsy or postnatal surgery,ultrasound and MRI,and the diagnostic accuracy of MRI and ultrasound was compared,respectively,the advantages of MRI combined with ultrasound in the diagnosis of MCDK was also analyzed.Results Among 104 fetuses diagnosed as MCDK by MRI,there were 102 cases with MCDK and 2 cases with misdiagnoses.Amniotic fluid was obviously reduced or absent in 4 cases.Among the 102 cases of MCDK,58 cases(56.9%)were correctly diagnosed as MCDK by ultrasound,40 cases(39.1%)were identified with polycystic alterations,without diagnosed as MCDK,and 4 cases(3.9%)were misdiagnosed as other diseases(1 case with adult polycystic kidney,1 case with multiple renal cyst and 2 cases with renal absence).Conclusion Compared with prenatal ultrasound,prenatal MRI can obtain more information,especially in oligohydramnios and maternal obesity affecting the quality of ultrasound image.MRI can be used as a reliable supplementary method of prenatal ultrasound.

关 键 词：胎儿 多囊性发育不良肾 磁共振成像 超声检查 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.1[医药卫生—诊断学] R714.43[医药卫生—临床医学]