MRI联合超声在异常双胎妊娠中的应用价值

目的:探讨MRI联合超声在异常双胎妊娠中的应用价值。方法:回顾性分析经我院产前超声和MRI联合检出的40例异常双胎妊娠,并于分娩、引产或手术后证实,回顾性分析产前MRI影像图象和检查结果。结果:40例双胎中,其中双绒双羊12例,单绒双羊有24例,单绒单羊4例。胎儿检出异常有1胎胎死宫内、另一胎正常有10例,其中1例合并宫内完全性葡萄胎;1例双胎均胎死宫内;1胎胎死宫内、另一胎儿颅内出血有4例;1胎正常,其余胎儿合并畸形共有25例,其中合并一胎儿侧脑室扩张有22例、后颅窝池扩张1例、胼胝体缺如有2例、透明隔缺如合并胼胝体缺如有1例。MRI检出母体胎盘异常有完全性前置胎盘6例、部分性前置胎盘1例、胎盘植入2例;母体并发症有1例合并母体子宫平滑肌瘤;1例母体内脏转位。母体并发症有一侧附件区囊肿3例,均为黄体囊肿;1例并发有右侧卵巢粘液性囊腺瘤和左侧卵巢成熟性畸胎瘤。结论:产前MRI联合超声能准确的检出异常双胎妊娠以及其他合并症,对尽早的指导临床干预并采取有效措施、减少不良妊娠结局具有重要的意义。

Application value of MRI combined ultrasound in abnormal twin pregnancy

Objective To explore the application value of MRI combined ultrasound in abnormal twin pregnancy.Methods Retrospective analysis of 40 cases of abnormal twin pregnancy detected by prenatal ultrasound and MRI in our hospital,confirmed by delivery,labor induction or surgery,retrospective analysis of prenatal MRI images and examination results.Results Among the 40 twins,there were 12 cases of double fleece,24 cases of single fleece and 4 cases of single fleece.There were 10 cases of abnormal fetal detection,including 1 case with complete intrauterine hydatidiform mole.In 1 case,both twins died in utero.There were 4 cases of intrauterine or intracranial hemorrhage in 1 fetus.In 1 case,both twins died in utero.One fetus was normal,and there were 25 cases of other fetuses combined with malformation,including 22 cases of lateral ventricle dilatation in one fetus,1 case of posterior fossa cisterna dilatation,2 cases of corpus callosum absence,and 1 case of transparent septum absence combined with corpus callosum absence.There were 6 cases of complete placenta previa,1 case of partial placenta previa and 2 cases of placenta implantation.Maternal complications included 1 case of uterine leiomyoma.Translocation of maternal viscera in 1 case.Maternal complications included 3 cases of unilateral adjunctive cysts,all of which were luteal cysts.One case was complicated with mucinous cystadenoma of the right ovary and mature teratoma of the left ovary.Conclusion Prenatal MRI combined with ultrasound can accurately detect abnormal twin pregnancy and other complications,which is of great significance for guiding clinical intervention as early as possible and taking effective measures to reduce adverse pregnancy outcomes.