MRI在产前诊断胎儿唇腭裂畸形中的应用价值

目的:探讨MRI在产前诊断胎儿唇腭裂中的应用价值.方法:搜集产前超声诊断可疑颌面部发育异常的胎儿52例,超声检查后1周内行胎儿MR I检查,分析胎儿唇部、上下牙槽突及腭部的超声、MR I影像特征.以(引)产后随访结果为金标准,将MR I、超声诊断结果与(引)产后随访结果进行对比分析.采用ROC曲线对比分析两种检查方法对...

The application value of magnetic resonance imaging in the prenatal diagnosis of fetal cleft lip and palate deformity

Objective:The purpose of this study was to explore the application value of magnetic resonance imaging(MRI)in the prenatal diagnosis of fetal cleft lip and palate.Methods:A retrospective analysis of 52 fetuses with suspected maxillofacial dysplasia by prenatal ultrasound was performed.All fetuses underwent MRI scan within 1 week thereafter.The ultrasonic and MRI features of fetal lip,upper and lower alveolar process and palate were analyzed.Taking the induced labour or postpartum follow-up results as the gold standard,the MRI and ultrasound diagnostic results were compared.ROC(software SPSS 23.0)curve was used to compare and analyze the diagnostic efficacy of the two examination methods.Results:In 52 patients,6 cases were confirmed by induced labour follow-ups,30 cases were confirmed by after delivery,16 cases of induced labour were not confirmed without autopsy.In the 36 confirmed cases,12 cases(33.33%)were diagnosed with cleft lip,22 cases(61.11%)with cleft lip and palate,and 2 cases(5.56)were healthy.Among them,34 cases were diagnosed accurately by MRI(12 cases of cleft lip,22 cases of cleft lip and palate),2 cases were misdiagnosed.30 cases were diagnosed accurately by ultrasound(10 cases of cleft lip,20 cases of cleft lip and palate),and 6 cases were misdiagnosed.The accuracy rate of MRI and ultrasound for diagnosing cleft lip was consistent with 94.44%(34/36),and the difference was not statistically significant.The accuracy rate of MRI in the diagnosis of cleft palate was 100%(36/36)which is higher than that of ultrasound of 88.89%(32/36),and the difference was statistically significant(χ²=4.235,P<0.05).The sensitivity and specificity of MRI in the diagnosis of cleft palate were 100%(22/22)and 100%(14/14);The sensitivity and specificity of ultrasonography in the diagnosis of cleft palate were 90.91%(20/22)and 14.29%(2/14).The area under the ROC curve(AUC)of magnetic resonance and ultrasound diagnosis of cleft lip and palate were 1.000 and 0.883,respectively.The MRI findings of fetal cleft palate images showed that the signal of fetal palate tissue was discontinuous,partially interrupted by long T₂W high signal,and the oral cavity was directly connected with the nasal cavity.Conclusion:MRI and ultrasound have the same application value in diagnosing fetal cleft lip malformations,but MRI has obvious advantages over ultrasound in the diagnosis of cleft palate malformations.MRI has a higher clinical application value in prenatal screening of fetal cleft palate malformations.