MRI在孕中晚期胎儿侧脑室扩张中的临床应用价值

目的运用MRI探讨孕中晚期胎儿侧脑室扩张中的临床应用价值。方法以产前超声发现胎儿侧脑室扩张并于3天内进行MRI检查的352例胎儿进行对比研究。结果双侧侧脑室扩张合并中枢神经系统疾病种类较单侧侧脑室扩张明显增多。单侧侧脑室扩张以左侧侧脑室扩张所占比例最多,合并中枢神经系统疾病发生率左、右侧间无统计差异。单、双侧脑室扩张合并中枢神经系统疾病发生率,10~12mm、13~15mm、16~20mm间合并其他中枢神经系统异常的发生率无统计学差异,单、双侧脑室扩张>20mm组合并其他中枢神经系统异常发生率较前三组明显增加。双侧侧脑室扩张合并其他中枢神经系统异常发生率较单侧侧脑室扩张者明显增大。侧脑室扩张合并其他中枢神经系统异常与孕周、BPD因素相关。磁共振测量BPD与超声测量值无统计学差异;侧脑室测量值与超声测量值比较存在统计学差异。MRI诊断结果对超声诊断做出有效补充:单侧扩张合并其他中枢神经系统异常补充诊断6例,双侧扩张合并合并其他中枢神经系统异常补充诊断59例。结论 MRI在评估中晚期妊娠胎儿侧脑室扩张及是否合并其他中枢神经系统异常的产前诊断中有较大的临床应用价值。产前超声发现胎儿侧脑室中重度扩张,尤其是双侧侧脑室中重度扩张者,非常有必要进一步MRI检查以明确是否合并其他中枢神经系统异常。

To Evalute the Diagnostic Value of MRI on Fetal Ventriculomegaly in Mid-late Pregnancy

Objective To evalute the diagnostic value on fetal ventriculomegaly in middle and late pregnancy by using MRI. Material and Methods A comparative study was performed in 352 fetuses with fetal ventricle dilatation and prenatal ultrasound examination performed within 3 days. Results The types of bilateral lateral ventricular dilatation combined with central nervous system diseases were significantly more than unilateral ventricular dilatation. There was no statistical difference in the incidence of central nervous system disease between left and right sides. There was no significant difference in the incidence of other central nervous system abnormalities between 10-12 mm, 13-15 mm and 16-20 mm. The incidence of other central nervous system abnormalities in the combination of single and bilateral ventricular dilatation>20 mm was significantly higher than that in the first three groups. Bilateral lateral ventricular dilatation with other central nervous system abnormalities than the unilateral lateral ventricle expansion was significantly increased. Lateral ventricle dilation combined with other central nervous system abnormalities and gestational age, BPD factors. There was no statistical difference between BPD and ultrasound measurements. There was significant difference between lateral ventricle measurement and ultrasonic measurement. MRI diagnosis of ultrasound diagnosis to make an effective supplement: unilateral expansion combined with other central nervous system abnormalities in 6 cases of supplementary diagnosis, bilateral expansion combined with other central nervous system abnormalities added 59 cases of diagnosis. Conclusion MRI is of great clinical value in the prenatal diagnosis of fetal lateral ventricle dilation and other central nervous system abnormalities. It is necessary to carry out further MRI examination to determine whether there are other central nervous system abnormalities.