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[胎儿脑磁共振成像与脑室扩大]

[Cerebral fetal MRI and ventriculomegaly].

作者信息

Launay S, Robert Y, Valat A S, Thomas D, Devisme L, Rocourt N, Vaast P

机构信息

Service de radiologie et d'imagerie médicale, Hôpital Jeanne de Flandre, 2, avenue Oscar Lambret, 59037 Lille cedex.

出版信息

J Radiol. 2002 Jun;83(6 Pt 1):723-30.

Abstract

OBJECTIVE

To evaluate MRI usefulness in diagnosis and management of fetuses with cerebral ventriculomegaly at US.

PATIENTS AND METHODS

Sonography depicted cerebral ventriculomegaly in 61 fetuses. Management included MRI in all cases and infectious screening, and karyotype in 51 cases. Final diagnosis was supported by fetal autopsy (n=24), postnatal follow-up>6 months (n=19), infectious screening or karyotype (n=8), and MR imaging when diagnosis was obvious (n=16).

RESULTS

MRI was more informative than ultrasonography in 32.8% of cases with identification of the etiology in 21.3% of cases. In 45% MRI and sonography were considered to be normal. In the remaining cases, MRI confirmed the ultrasound diagnosis of cerebral malformation. Ultrasonography never depicted more anomalies than MR imaging. The 2 false negatives were gyration disorders but MR imaging was performed too early.

CONCLUSION

US is the imaging modality of choice in the evaluation of fetal anomalies but MRI has to be systematically performed in case of cerebral ventriculomegaly because MRI demonstrates its usefulness in patient counseling, even if there are a few false negative results.

摘要

目的

评估磁共振成像(MRI)在超声检查发现脑室扩大的胎儿诊断及处理中的作用。

患者与方法

超声检查发现61例胎儿脑室扩大。所有病例均进行了MRI检查,51例进行了感染筛查及核型分析。最终诊断依据胎儿尸检(n = 24)、出生后6个月以上随访(n = 19)、感染筛查或核型分析(n = 8)以及诊断明确时的MR成像(n = 16)。

结果

在32.8%的病例中,MRI提供的信息比超声更多,21.3%的病例明确了病因。45%的病例中,MRI和超声均显示正常。其余病例中,MRI证实了超声诊断的脑部畸形。超声显示的异常从未多于MR成像。2例假阴性为脑回形成异常,但MR成像检查时间过早。

结论

超声是评估胎儿异常的首选影像学检查方法,但对于脑室扩大的病例必须系统地进行MRI检查,因为MRI在为患者提供咨询方面显示出其作用,即使存在少数假阴性结果。

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