产前超声、MRI检查对胎儿脑室孔闭塞综合征检出及诊断价值对比

目的探讨产前超声、核磁共振(MRI)检查对胎儿脑室孔闭塞(Dandy-Walker)综合征检出及诊断价值。方法收集2018年1月至2018年12月于我院确诊为Dandy-Walker综合征的22例胎儿的资料,比较产前超声和MRI对Dandy-Walker综合征的检出诊断率,并总结其影像学特征。结果产前MRI检查对Dandy-Walker综合征和合并其他中枢神经系统畸形的检出正确诊断率均显著高于超声检查(P<0.05);超声诊断Dandy-Walker综合征中10例均表现为小脑蚓部完全缺失,小脑半球呈现分开外展状态,第四脑室和后颅窝池相同并扩张,且两者相通。4例小脑下蚓部缺失或发育不良,侧冠状切面上可见蚓部缺失,两半球分开,小脑延髓池增宽。MRI诊断Dandy-Walker综合征中有6例出现小脑蚓部完全缺失,14例表现为小脑蚓部发育不良,可见小脑半球分离,小脑延髓池与第四脑室相通,小脑延髓池及第四脑室增宽,后颅窝扩大,及天幕及窦汇抬高,幕上脑积水。其中MRI诊断合并胼胝体发育不良8例和透明隔缺如4例。结论MRI产前诊断Dandy-walker综合征优势更为明显,可更为清晰地显示胎儿小脑发育结构和生长情况,在超声检查基础上采用MRI进行补充检查,可进一步提高产前Dandy-walker综合征的正确诊断率。

Comparison of Prenatal Ultrasonography and MRI in the Detection and Diagnosis of Fetal Ventricular Hole Occlusion Syndrome

Objective To explore that prenatal ultrasonography and magnetic resonance imaging(MRI)were used to detect fetal ventricular hole-occlusion syndrome(dacandy-Walker)and diagnostic value.Methods Data were collected from 22 fetuses diagnosed with Dandy-Walker syndrome in our hospital from January 2018 to December 2018.The diagnostic rates of Dandy-Walker syndrome in prenatal ultrasound and MRI were compared and we summarize the imaging features.Results The correct diagnosis rate of prenatal MRI examination for Dandy-Walker syndrome and other central nervous system malformations was significantly higher than that of ultrasound exa mination(P<0.05).10 cases of ultrasound diagnosis of Dandy-Walker syndrome were shown complete loss of cerebellar vermis,and cerebellar hemisphere was showed a sepa rate abduction,the fourth ventricle and posterior fossa pool were the same and expanded,and the two were connected.In 4 cases,the inferior vermis was absent or stunted.The vermis was missing on the lateral coronal section,the two hemispheres were separated,and the cerebellar medullary cistern was widened.In the MRI diagnosis of Dandy-Walker syndrome,6 cases were presented with complete vermis absence,and the remaining 14 cases were presented vermis dysplasia.Separation of the cerebellar hemisphere was observed.The cerebellar medullary cistern was connected with the fourth ventricle,the cerebellar medullary cistern and the fou rth ventricle were widened,the posterior fossa was enla rged,and the tentorium and sinusitis were elevated,Supratentorial hydrocephalus.Among them,there were 8 cases of MRI diagnosis combined with corpus callosum dysplasia and 4 cases of the transparent septum.Conclusion MRI prenatal diagnosis of Dandy-walker syndrome has more obvious advantages,which can more clearly show the development and growth of fetal cerebellum.Based ultrasound examination,MRI supplementary exa mination can further improve the correct diagnosis rate of prenatal Dandy-walker syndrome.