产前超声和MRI在诊断胎儿畸形中的应用

目的探讨产前超声和MRI对诊断胎儿各个系统结构畸形的应用价值.方法 回顾性分析同时接受产前超声和MR检查的1205胎异常胎儿的超声和MRI特征,并与最终随访结果相对照.结果 1205胎各类异常共1341胎次,包括中枢神经系统异常594胎次、泌尿生殖系统及肾上腺异常245胎次、胸腔异常(不包括心脏畸形)188胎次、消化系统异常97胎次、胎儿肿瘤(不包括肝、肾及颅内肿瘤)83胎次、骨骼畸形51胎次、多胎畸形42胎次、腹壁异常33例胎次、颜面异常8胎次.上述各个系统胎儿畸形中产前超声诊断符合率分别为81.99%、85.31%、85.64%、78.35%、92.77%、100%、100%、100%、100%、100%;MRI分别为92.76%、98.37%、95.21%、93.81%、96.39%、74.51%、100%、87.88%、87.50%.结论 产前超声及MR检查均有助于胎儿异常的诊断.明确胎儿各类异常的MRI指征,可为临床合理选择产前影像学检查提供依据.

Application of prenatal ultrasound and MRI in fetal abnormalities

Objective To explore the application value of prenatal ultrasound and MRI in each fetal structures abnormality. Methods Prenatal ultrasound and MRI data of totally 1205 abnormality fetuses were analyzed retrospectively. The results of imaging examinations were compared with those of the final follow-up. Results There were 1341 abnormalities in 1205 fetuses, including central nervous system abnormalities (594 abnormalities), urogenital system and adrenal gland abnormalities (245 abnormalities), thorax abnormalities (except of congenital heart disease, 188 abnormalities), digestive system abnormalities (97 abnormalities), fetus tumours (except of hepatic, renal and intracranial tumors, 83 abnormalities), skeleton abnormalities (51 abnormalities), multifetal abnormalities (42 abnormalities), abdominal wall abnormalities (33 abnormalities)and facial abnormalities(8 abnormalities). For each of above fetal structures abnormalities, the diagnostic accuracy rates of ultrasound was 81.99%, 85.31%, 85.64%, 78.35%, 92.77%, 100%, 100%, 100%, 100%, 100%, respectively. And the diagnostic accuracy rate of MRI was 92.76%, 98.37%, 95.21%, 93.81%, 96.39%, 74.51%, 100%, 87.88%, 87.50%, respectively. Conclusion Both of were helpful to diagnose fetal abnormality. Identifying the indications of MRI in fetal each structures abnormalities can provide clinical basis for reasonable application of fetal MR scan.