基于3.0 T MRI的二维定量指标在胎儿肱骨发育评估中的应用价值

目的 探讨基于3.0 T MRI的二维定量指标在胎儿肱骨发育评估中的应用价值。方法 回顾性研究。纳入2018年1月—2021年10月泰安市中心医院74例非生长发育受限胎儿的MRI资料。受检孕妇年龄20~46（30.8±5.9）岁,孕周26~37（32.7±3.4）周。采集真实稳态进动快速成像（TrueFISP）序列MRI,测量胎儿肱骨的二维定量指标（肱骨干长度,肱骨近侧和远侧软骨骨骺横径、前后径、高径,以及肱骨总长度）。应用Pearson相关分析二维定量指标与孕龄的相关性;观察肱骨近侧和远侧次级骨化中心的出现时间。结果 胎儿肱骨干长度、肱骨总长度和肱骨近侧软骨骨骺前后径均与孕龄呈高度正相关（r=0.83、0.84、0.72,P值均<0.001）;胎儿肱骨近侧软骨骨骺横径和肱骨远侧软骨骨骺横径、前后径、高径均与孕龄呈中度正相关（r=0.64、0.56、0.53、0.53,P值均<0.001）;胎儿肱骨近侧软骨骨骺高径与孕龄呈低度正相关（r=0.38,P=0.001）。肱骨远侧次级骨化中心最早出现时间在36~37⁺⁶周,26~35⁺⁶周均未见;26~37⁺⁶周胎儿肱骨近侧均未出现次级骨化中心。结论 基于3.0 T MRI的二维定量指标可较好评估孕龄26~37⁺⁶周胎儿肱骨生长发育,可为产前诊断胎儿肱骨疾病提供参考依据。

Value of two-dimensional quantification based on 3.0 T magnetic resonance imaging in the assessment of fetal humeral development

Objective This study aims to investigate the value of 3.0 T magnetic resonance imaging (MRI) in two-dimensional quantitative evaluation of fetal humeral development. Methods A retrospective design was adopted. The MRI data of 74 non-growth-restricted fetuses in Tai'an City Central Hospital from January 2018 to October 2021 were included. The tested pregnant women were aged 20 to 46 (30.8±5.9) years old and had gestational age of 26-37(32.7±3.4) weeks. Fetal MRI data were collected by true steady-state advance rapid imaging (TrueFISP) sequences. The TrueFISP sequence measured the two-dimensional diameter index of fetal humerus (humeral shaft length, transverse diameter, anterior and posterior diameter, high diameter of the proximal and distal humerus cartilage epiphysis, and total length of humerus). The correlation between two-dimensional diameter index and gestational age was analyzed by linear correlation. The time of the secondary ossification center of the humerus was observed. Results The length of humeral shaft, the total length of humerus, and the anterior and posterior diameter of proximal humerus cartilage epiphysis were highly positively correlated with gestational age (r=0.83, 0.84, 0.72, all P values <0.001). The transverse diameter of proximal and distal humerus cartilage epiphysis, the anterior and posterior diameter of distal humerus cartilage epiphysis, and height diameter of distal humerus cartilage epiphysis were moderately positively correlated with gestational age (r=0.64, 0.56, 0.53, 0.53, all P values <0.001). The height diameter of fetal proximal humerus cartilage epiphysis was positively correlated with gestational age (r=0.38, P=0.001). The earliest occurrence of distal humeral secondary ossification centers was observed at 36-37⁺⁶ weeks, but did not appear at 26-35⁺⁶ weeks, and the proximal secondary ossification centers did not appear at 26-37⁺⁶ weeks. Conclusion Two-dimensional quantitative indicators based on 3.0 T MRI can evaluate the growth and development of fetal humerus from 26 to 37^{+ 6} weeks of gestational age and provide a new reference for prenatal diagnosis of fetal humerus diseases.