产前MRI对法洛氏四联症胎儿脑深层灰质体积的量化评估  

Prenatal MRI quantified the deep gray matter volume of the fetal brain in tetralogy of Fallot

作　　者：任婧雅 董素贞 REN Jingya;DONG Suzhen(Department of Radiology,Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心放射科,上海200127

出　　处：《磁共振成像》2024年第9期29-32,40,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:81971582);上海市2023年度“科技创新行动计划”医学创新研究专项项目(编号:23Y11907800);中央高校基本科研业务费专项资金(编号:YG2023ZD22)。

摘　　要：目的探讨通过产前MRI量化评估法洛氏四联症(tetralogy of Fallot,TOF)胎儿脑深层灰质(deep gray matter,DGM)体积与正常对照组胎儿的差异和价值。材料与方法60名孕龄(gestational age,GA)19~33周单胎妊娠孕妇接受产前胎儿MRI检查,其中30例TOF胎儿的平均GA为(25.30±3.65)周(其中15例<26周,15例≥26周);30例脑发育正常胎儿(对照组)的平均GA为(25.83±3.98)周(其中15例<26周,15例≥26周)。采用单次激发快速自旋回波(single-shot turbo spin echo,SSTSE)序列采集胎儿脑MRI,经图像后处理后手动分割大脑,测量胎儿脑左右两侧DGM三维体积。分别对两组胎儿脑DGM体积与GA进行回归分析,并比较两组胎儿脑DGM体积的差异以及左右侧DGM体积是否具有对称性。结果比较分析发现两组胎儿左右侧脑DGM体积差异均无统计学意义。GA<26周TOF组胎儿脑DGM体积小于对照组(t=2.90,P=0.007);GA≥26周TOF组DGM体积也较对照组脑DGM体积减小(t=2.11,P=0.04),差异均有统计学意义。结论TOF组胎儿脑DGM体积在妊娠早中期发育轨迹较正常胎儿已出现了差异,并在妊娠中晚期随着胎儿脑体积的快速增长,两者发育轨迹的差异依旧存在,可为产前量化评估TOF胎儿脑发育异常提供参考。Objective:To quantitatively evaluate the difference of deep gray matter(DGM)volume in fetuses with tetralogy of Fallot(TOF)compared with normal fetuses by prenatal MRI.Materials and Methods:Sixty single pregnant women with gestational age(GA)of 19-33 weeks received prenatal fetal MRI examination,of which 30 fetuses with TOF had an average GA of(25.30±3.65)weeks,including 15 cases GA<26 weeks and 15 cases GA≥26 weeks.The average GA(25.83±3.98)weeks was normal in 30 cases(control group),including 15 cases GA<26 weeks and 15 cases GA≥26 weeks.Fetal MRI was collected using single-shot turbo spin echo(SSTSE)sequence.After image post-processing,the brain was manually divided and the three-dimensional volume of DGM on both sides of the fetal brain was measured.The DGM volume and GA of fetal brain were analyzed by regression,and the difference of DGM volume and the symmetry of left and right DGM volume between the two groups were compared.Results:There was no significant difference in DGM volume between the two groups.The fetal DGM volume of GA<26 weeks TOF group was lower than that of normal control group(t=2.90,P=0.007).DGM volume of the TOF group with GA≥26 weeks was also decreased compared with the normal control group(t=2.11,P=0.04),and the differences were statistically significant.Conclusions:Fetal DGM volume in the TOF group was different from that of normal fetuses in the first and second trimester of pregnancy,and the difference still existed in the second and third trimester of pregnancy with the rapid growth of fetal brain volume,which could provide reference for quantitative prenatal assessment of fetal brain development abnormalities of TOF.

关 键 词：胎儿 大脑 磁共振成像 法洛氏四联症 深层灰质体积 

分 类 号：R445.2[医药卫生—影像医学与核医学] R541.1[医药卫生—诊断学]