摘要
目的探讨MRI在胎儿先天性膈疝诊断中的应用价值。方法14名孕妇，孕龄16～39周。产前常规行超声（US）检查怀疑胎儿先天性膈疝后在24～48h内行MR检查，采用二维快速平衡稳态采集（2DFIESTA）序列、单次激发快速自旋回波（SSFSE）序列以及快速反转恢复运动抑制（FIRM）序列，行胎儿颅脑、胸、腹部常规及胸腹部重点冠状面、矢状面及横断面扫描，将产前MRI、US表现与出生后影像表现或手术（13例胎儿）、引产后尸体解剖（1例胎儿）结果对照。结果12例为单胎，2例为双胎之一。膈疝位于左侧12例，右侧2例。随访结果与产前MRI诊断完全一致，产前us误诊2例、漏诊2例。12例左侧疝中1例为左胸部被巨大结肠占据，1例仅整个胃泡疝入，5例仅部分肠管疝人，5例整个胃泡和部分肠管同时疝人；2例右侧疝中1例仅部分肠管疝入，1例为肝脏部分和部分肠管同时疝入。结论MRI对胎儿先天性膈疝诊断具有较高的应用价值。
Objective To explore the diagnostic value of MRI on fetal congenital diaphragmatic hernia （CDH）. Methods Fourteen pregnant women with gestation from 16 to 39 weeks were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies. Fast-imaging employing steady-state acquisition （FIESTA）, single-shot fast spin echo （SSFSE） and T1-weighted fast inversion recovery motion insensitive （FIRM） sequences were employed on the axial, coronal and sagittal planes of the fetal brain, thorax and abdomen, especially the thorax. Prenatal US and MR imaging findings were compared with postnatal diagnoses （13 fetuses） or autopsy （1 fetus）. US, MR imaging and surgery were used for postnatal evaluation. Results Fourteen pregnant women （12 with a single fetus and 2 with twin fetuses） were studied. There were 12 fetuses （ in 2 cases, being one of twins） with a left-sided and 2 with right-sided diaphragmatic hernias. For all cases, the prenatal MRI diagnosis was correct when compared with postnatal diagnosis or autopsy. Two CDHs were missed and 2 were misdiagnosed by US. Intrathoracic herniated organs in 12 left CDH included the colon （ n = 1 ） , the stomach （ n = 1 ）, the bowel （ n = 5 ）, or both the stomach and bowel （ n = 5）. Intrathoracic herniated organs in 2 right CDH included the bowel （ n = 1 ）, or the bowel and the right lobe of the liver （n = 1 ）. Conclusion Prenatal MRI is effective in the assessment of fetal congenital diaphragmatic hernia.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2009年第11期1148-1151,共4页
Chinese Journal of Radiology
基金
上海市“创新行动计划”项目基础研究重点项目（07JC14043）
上海市卫生局青年科研项目（2008Y116）
关键词
胎儿
疝
横膈
肺
磁共振成像
Fetus
Hernia, diaphragmatic
Lung
Magnetic resonance imaging
