产前MRI对胎儿卵巢囊肿的诊断价值

目的探讨产前MRI在胎儿卵巢囊肿中的诊断价值。方法回顾性分析产前诊断及手术确诊的40例胎儿卵巢囊肿的产前、产后MRI影像特征。结果产前MRI检查胎儿卵巢囊肿发生于单侧38例,双侧2例。病灶形态均为类圆形或椭圆形,边界光滑,囊壁较薄。32例病灶内部信号较均匀,T1WI呈均匀低或稍高信号,T2WI呈高信号,DWI扩散不受限,ADC图呈高信号;8例病灶内信号较混杂,T1WI呈稍低及稍高信号,T2WI呈不均匀的稍低信号并夹杂斑片状、点状高信号影,DWI部分扩散受限,ADC图呈低信号。病灶邻近的肠管均受压推移。产后随访发现20例肿块自行消退。有8例行腹腔镜探查手术,病理显示7例为卵巢单纯性囊肿伴出血,1例卵巢囊肿合并蒂扭转。结论产前MRI不仅能清晰显示胎儿卵巢囊肿的发生部位、形态、边界、范围、信号特点,还可评估肿块与邻近组织的结构以及其他合并症,能更好地为临床评估预后和产后治疗提供可靠的诊断依据。

The value of prenatal MRI in diagnosis of fetal ovarian cyst

Objective To explore the value of prenatal MRI in diagnosis of fetal ovarian cyst.Methods The prenatal and postnatal MRI features of 40 fetuses with fetal ovarian cysts diagnosed by prenatal diagnosis and operation were retrospectively analyzed.Results Prenatal MRI showed unilateral ovarian cyst in 38 cases and bilateral in 2 cases.The cysts were round or oval with a smooth boundary and thin capsule wall.The internal signal was relatively uniform in 32 cases,and presented uniform low or slightly high signal on T1WI,high signal on T2WI.The diffusion was not restricted on DWI,and ADC map showed hyperintensity.Heterogeneous signal was identified in 8 cases,the cysts showed mild hypointensity and mild hyperintensity on T1WI,heterogeneous mild hypointensity with patchy and punctate hyperintensity on T2WI.The diffusion was restricted in part of the cystson DWI,and ADC showed hypointensity.The adjacent intestinal canal was compressed.After delivery,the follow-up MRI showed that the cysts subsided spontaneously in 20 patients.Eight patients underwent laparoscopic exploration,and pathology revealed simple ovarian cyst with hemorrhage in 7 patients,and ovarian cyst with pedicle torsion in 1 case.Conclusion Prenatal MRI can not only clearly show the location,shape,boundary,range and signal characteristics of fetal ovarian cyst,but also evaluate the structure of the cysts,its adjacent tissues,and other complications,which are useful information for the prognosis evaluation and postpartum treatment.