超声联合磁共振成像在胎儿疾病诊断中的应用

目的: 探讨超声联合核磁共振成像（magnetic resonance imaging,MRI）在临床胎儿疾病诊断中的应用。方法: 回顾性分析2015年1月—2019年7月177例超声检测胎儿胸腔或腹腔异常的患者,并通过MRI进一步检测,排除失访和未复查的病例,按照MRI诊断结果进行分组,并根据随访所获得的妊娠结局分析超声诊断准确率。结果: 超声和MRI检测胎儿呼吸系统、泌尿系统异常的结果较一致,超声和MRI完全符合的比例分别45.9%和53.8%;在胎儿消化系统异常和卵巢囊肿方面,MRI多补充超声结果,MRI补充超声诊断的比例分别为57.7%和80%。MRI诊断胎儿消化系统疾病时,其准确率高于超声（P<0.05）;MRI与超声检测结构异常和回声增强的准确率之间差异无统计学意义（均P>0.05）。结论: 超声检测胎儿呼吸系统和泌尿系统疾病诊断信息不充分时可选择MRI诊断;超声检测胎儿消化系统异常和卵巢囊肿时,无论结构异常还是回声增强,建议MRI检测。

The Application of Ultrasound Combined with MRI in Diagnosis of Fetal Diseases

Objective: To explore the application of ultrasound alone and ultrasound combined with magnetic resonance imaging (MRI) in the diagnosis of fetal diseases. Methods: 177 pregnant women with abnormal fetal detected by ultrasound, and further examined by MRI, were selected from January 2015 to July 2019. Those cases with lost follow-up and without reexamination were excluded. The cases were then divided into groups according to MRI diagnosis results. The accuracy rates of ultrasound and/or MRI diagnosis according to the pregnancy outcomes were analyzed.Results: The result of ultrasound and the result of MRI were consistent in diagnosing the fetal respiratory system and urinary system, and the proportions of exact match were 45.9% and 53.8%, respectively. MRI mostly supplemented the results of ultrasound when using in the diagnosis of the fetal digestive system disease and ovarian cyst, with the supplemental proportion of 57.7% and 80%, respectively. The accuracy rate of MRI in the diagnosis of digestive system diseases was significantly higher than that of ultrasound (P<0.05); there was no obvious difference between the accuracy rate of MRI and ultrasound in detecting structural abnormalities and echo enhancement (allP<0.05).Conclusions: In case of fetal respiratory and urinary system disease detected by ultrasound, MRI can be suggested when the ultrasonic diagnosis information was insufficient. When detecting fetal digestive system disease and ovarian cysts, MRI was better recommendation regardless of the structural abnormalities or echo enhancement found by ultrasound.