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[磁共振成像作为产前诊断工具在补充超声诊断胎儿及妊娠异常中的应用]

[Magnetic resonance imaging as a prenatal diagnostic tool supplementary to ultrasound in diagnosing fetal and gestational abnormalities].

作者信息

Porat Shay, Agid Ronit, Elchalal Uriel, Ezra Yossi, Gomori J Moshe, Nadjari Michelle

机构信息

Dept. of Obstetrics and Gynecology, Hadassah Mt. Scopus Hospital, Jerusalem.

出版信息

Harefuah. 2002 Apr;141(4):329-34, 412, 411.

Abstract

The use of Magnetic Resonance Imaging (MRI) as a prenatal and gestational imaging modality supplementary to ultrasound has become widespread with the advent of rapid MR sequences in the last few years. These sequences allow acquisition of high-resolution images of the fetus in a single breath-holding period of the mother, with minimal fetal motion artifacts. We describe our experience with this modality in the diagnosis of prenatal and gestational abnormalities. The study population consisted of 39 pregnant women who had a total of 40 MRI examinations from 7/1998 to 7/2000. The indication for all examinations was a suspected fetal or gestational abnormality as suggested by ultrasound scan, laboratory tests or by family history. In 31 cases (77.5%) a correlation was found between the ultrasound findings and the MR imaging, of which in 6 cases (15%) the MRI added new valuable information. In 9 cases (22.5%) the MRI ruled out findings suspected by ultrasound. The prenatal findings were compared with postnatal clinical follow-up, imaging or pathology report in 26 cases (66.6%). In two cases the clinical outcome and postnatal imaging were discordant with the prenatal imaging findings in ultrasound and MRI. Although not proven, MRI is considered safe during pregnancy because it does not use ionizing radiation. It depicts fetal anatomy and pathology well. Also uterine, placental and other maternal structures are well demonstrated. This tool is useful in cases in which there is a suspicion of a malformed fetus or abnormal placenta by an ultrasound examination or in cases in which an ultrasound examination is limited by technical factors. MRI was found to help parents and doctors decide about the fate of a suspected abnormal pregnancy by adding valuable information supplemental to ultrasound examination.

摘要

近年来,随着快速磁共振序列的出现,磁共振成像(MRI)作为超声之外的一种产前及孕期成像方式已得到广泛应用。这些序列能够在母亲单次屏气期间获取高分辨率的胎儿图像,且胎儿运动伪影最少。我们描述了我们使用这种成像方式诊断产前及孕期异常的经验。研究对象包括39名孕妇,她们在1998年7月至2000年7月期间共接受了40次MRI检查。所有检查的指征均为超声扫描、实验室检查或家族史提示的可疑胎儿或孕期异常。在31例(77.5%)病例中,超声检查结果与磁共振成像之间存在相关性,其中6例(15%)MRI提供了新的有价值信息。9例(22.5%)病例中,MRI排除了超声检查怀疑的结果。26例(66.6%)病例的产前检查结果与产后临床随访、影像学或病理报告进行了比较。有2例病例的临床结局及产后影像学检查结果与产前超声和MRI检查结果不一致。尽管未经证实,但MRI在孕期被认为是安全的,因为它不使用电离辐射。它能很好地显示胎儿解剖结构和病理情况。子宫、胎盘及其他母体结构也能清晰显示。在超声检查怀疑胎儿畸形或胎盘异常,或超声检查受技术因素限制的情况下,这种检查手段很有用。通过提供补充超声检查的有价值信息,MRI有助于父母和医生对可疑异常妊娠的处理做出决策。

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