Rapp B, Perrotin F, Marret H, Sembely-Taveau C, Lansac J, Body G
Département Gynécologie Obstétrique, Médecine Foetale et Reproduction Humaine, Hôpital Bretonneau, 37044 Tours Cedex.
J Gynecol Obstet Biol Reprod (Paris). 2002 Apr;31(2 Pt 1):173-82.
To evaluate MR contribution to prenatal diagnosis and prognosis of corpus callosum agenesis suspected by ultrasound and to ascertain how and when this examination should be included part in prenatal management of such malformation.
During a six-year period from January 1st 1994 and December 31st 2000, fifteen patients (and fifteen fetuses) were referred to our fetal medicine unit with suspicion of corpus callosum agenesis on prenatal ultrasound. Cerebral MRI was performed in all cases to confirm prenatal diagnosis. In our study, prenatal MRI examinations were retrospectively studied and compared with neuropathological examinations (n=8) or postnatal imaging (n=6).
Corpus callosum agenesis were either complete (n=13) or partial (n=1). All were visible on prenatal MRI but only six on prenatal ultrasound. In one case, ultrasound suspicion of corpus callosum agenesis was ruled-out (false positive on prenatal ultrasound) by fetal cerebral MRI. In five cases corpus callosum agenesis was an isolated finding whereas in 12 cases associated malformations were encountered (cerebral n=7 or extra-cerebral n=5). MR depicted 7 of the 12 associated neurologic abnormalities.
Prenatal MRI is a valuable complementary technique for either diagnosis of corpus callosum agenesis and depiction of associated neurologic abnormalities. Superiority of MR on prenatal sonography and its help in post-mortem examination of the brain (help in the choice of the pathologic technique and localisation of the samples) makes it essential even when pregnancy termination is considered.
评估磁共振成像(MR)对超声怀疑胼胝体发育不全的产前诊断及预后的作用,并确定该检查应如何及何时纳入此类畸形的产前管理。
在1994年1月1日至2000年12月31日的六年期间,15例患者(及15例胎儿)因产前超声怀疑胼胝体发育不全被转诊至我们的胎儿医学科。所有病例均进行了脑部磁共振成像以确诊产前诊断。在我们的研究中,对产前磁共振成像检查进行了回顾性研究,并与神经病理学检查(n = 8)或产后影像学检查(n = 6)进行了比较。
胼胝体发育不全要么是完全性的(n = 13),要么是部分性的(n = 1)。所有病例在产前磁共振成像上均可见,但在产前超声上仅6例可见。在1例中,胎儿脑部磁共振成像排除了超声对胼胝体发育不全的怀疑(产前超声假阳性)。在5例中,胼胝体发育不全是孤立发现,而在12例中发现了相关畸形(脑部畸形n = 7或脑外畸形n = 5)。磁共振成像显示了12例相关神经异常中的7例。
产前磁共振成像是诊断胼胝体发育不全及描绘相关神经异常的有价值的辅助技术。磁共振成像在产前超声检查方面的优势及其对脑死后检查的帮助(有助于选择病理技术和样本定位)使得即使考虑终止妊娠时它也至关重要。