Wagenvoort A M, Bekker M N, Go A T, Vandenbussche F P, van Buchem M A, Valk J, van Vugt J M
Department of Obstetrics and Gynecology, Division of Prenatal Diagnosis and Therapy, University Hospital 'Vrije Universiteit', Amsterdam, The Netherlands.
Fetal Diagn Ther. 2000 Nov-Dec;15(6):364-72. doi: 10.1159/000021038.
To determine whether magnetic resonance (MR) can give additional information in prenatal diagnosis of congenital anomalies, when the ultrasound (US) analysis is not conclusive.
Ultrafast MR scanning examined 39 pregnant women with 41 fetuses in whom US was suspicious of fetal congenital abnormalities. Two techniques were used namely (1) HASTE inversion recovery sequence and (2) FISP 2D.
Thirty-nine patients with 41 fetuses were referred for MR because of an equivocal US with regard to brain, spine, skeletal and miscellaneous anomalies. In 1 twin pregnancy, 1 co-twin has not been examined with MRI because of its demise. In 22 of them, additional information was obtained by MR. In 9 the MR was confirmative with the US examination. Four were false negative, comparing with the postnatal diagnosis. Three failed because of maternal claustrophobia and in 2 a diagnosis could not be made. From the 40 fetuses in this study, 38 were examined postnatally by MR, US, plain X-ray or autopsy was performed to confirm the prenatal diagnosis.
The use of MRI in obstetrics has been limited, until recently. With fast MRI sequences it is not necessary to sedate the fetus. It is advisable in cases where US is equivocal concerning congenital anomalies of the fetus to use MR with fast or ultrafast scan technique, especially when the central nervous system is concerned.
当超声（US）分析不能得出结论时，确定磁共振成像（MR）在先天性异常的产前诊断中是否能提供额外信息。
对39例怀有41例胎儿的孕妇进行了超快磁共振扫描，这些胎儿的超声检查怀疑有先天性异常。使用了两种技术，即（1）HASTE反转恢复序列和（2）FISP 2D。
39例怀有41例胎儿的患者因超声对脑、脊柱、骨骼及其他异常的诊断不明确而被转诊进行磁共振成像检查。在1例双胎妊娠中，1个胎儿因死亡未进行磁共振成像检查。其中22例通过磁共振成像获得了额外信息。9例磁共振成像结果与超声检查结果一致。与产后诊断相比，4例为假阴性。3例因孕妇幽闭恐惧症检查失败，2例无法做出诊断。在本研究的40例胎儿中，38例在出生后通过磁共振成像、超声、X线平片或尸检进行检查以证实产前诊断。
直到最近，磁共振成像在产科的应用一直受到限制。使用快速磁共振成像序列无需对胎儿进行镇静。当超声对胎儿先天性异常的诊断不明确时，建议使用快速或超快扫描技术进行磁共振成像检查，尤其是涉及中枢神经系统时。
