Kubik-Huch R A, Huisman T A, Wisser J, Gottstein-Aalame N, Debatin J F, Seifert B, Ladd M E, Stallmach T, Marincek B
Department of Radiology, University Hospital Zürich, Switzerland.
AJR Am J Roentgenol. 2000 Jun;174(6):1599-606. doi: 10.2214/ajr.174.6.1741599.
We examined the capability of ultrafast single-shot fast spin-echo imaging to assess different fetal organ systems compared with prenatal sonography, using autopsy or postpartum imaging as a standard of reference.
Thirty women with complicated pregnancies (mean age of gestation, 190 +/- 54 days) underwent T2-weighted ultrafast MR imaging. MR images were analyzed with regard to diagnostic confidence in assessing abnormalities of fetal organ systems, and data were correlated with postpartum findings or necropsy. Results were compared with those of prenatal sonography.
Using receiver operating characteristic curve analysis, diagnostic confidence of MR imaging was best for assessing the brain (area under the curve [Az] = 0.96) and spinal canal (Az = 1.0), uteroplacental unit (Az = 0.93), and lungs (Az = 0.91). Results for the heart (Az = 0.63) and extremities (Az = 0.77) were significantly lower than that of other organs (p < 0.001). Diagnostic accuracy increased with gestational age. No statistically significant difference between sonography and MR imaging was found for the detection of abnormality in any organ system. In three fetuses, MR imaging was superior to sonography in characterizing cerebral abnormalities. MR imaging was inferior to sonography in characterizing abnormalities of the heart and extremities.
Our results indicate that ultrafast MR imaging can be used for in vivo fetal imaging, especially in assessing cerebral abnormalities. However, MR imaging should be restricted to situations in which sonographic findings are ambiguous or impaired.
我们使用尸检或产后影像学作为参考标准，研究了超快单次激发快速自旋回波成像与产前超声检查相比评估不同胎儿器官系统的能力。
30例妊娠合并症孕妇（平均孕周190±54天）接受了T2加权超快磁共振成像检查。分析磁共振图像对评估胎儿器官系统异常的诊断置信度，并将数据与产后检查结果或尸检结果进行关联。将结果与产前超声检查结果进行比较。
采用受试者工作特征曲线分析，磁共振成像对脑（曲线下面积[Az]=0.96）、椎管（Az=1.0）、子宫胎盘单位（Az=0.93）和肺（Az=0.91）的诊断置信度最佳。心脏（Az=0.63）和四肢（Az=0.77）的结果显著低于其他器官（p<0.001）。诊断准确性随孕周增加而提高。在任何器官系统中，超声检查和磁共振成像在检测异常方面未发现统计学上的显著差异。在3例胎儿中，磁共振成像在脑异常特征描述方面优于超声检查。磁共振成像在心脏和四肢异常特征描述方面不如超声检查。
我们的结果表明，超快磁共振成像可用于胎儿体内成像，尤其是在评估脑异常方面。然而，磁共振成像应仅限于超声检查结果不明确或有缺陷的情况。
