Zanders Erik H J, Buist Fayette C D, van Vugt John M G
Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands.
Fetal Diagn Ther. 2003 Sep-Oct;18(5):324-7. doi: 10.1159/000071974.
To determine whether magnetic resonance imaging (MRI) can give further information for the prenatal diagnosis of intracranial hemorrhage, when ultrasound (US) is not conclusive.
We report on a fetus in the 26th week of gestation with a grade-III hemorrhage in the right cerebral hemisphere, which was suspected on US examination and specified by MRI examination in a patient with pre-eclampsia.
Doppler measurement of the umbilical artery, which showed the absence of end diastolic velocity, was indicative of placental insufficiency. The MRI specified the findings found by US examination and confirmed the poor outcome of the fetus. Labor was induced by prostaglandins in the 27th week of gestation. Postmortem examination showed a female fetus with a grade-III intracranial hemorrhage in the center of the right hemisphere with a diameter of 4 cm. A hemorrhage was also found in the subarachnoid space and in the occipital region of the left hemisphere.
We suggest that fetuses at high risk of developing hypoxia should be sonographically evaluated and MRI should be considered when intracranial echogenicities are seen.
确定当超声（US）检查结果不明确时，磁共振成像（MRI）能否为颅内出血的产前诊断提供更多信息。
我们报告了一例妊娠26周的胎儿，其右侧脑半球有III级出血，在一名子痫前期患者中，超声检查怀疑有此情况，并通过MRI检查得以明确。
脐动脉的多普勒测量显示舒张末期血流速度消失，提示胎盘功能不全。MRI明确了超声检查发现的情况，并证实了胎儿预后不良。在妊娠第27周时用前列腺素引产。尸检显示为一名女胎，右侧半球中心有直径4厘米的III级颅内出血。在蛛网膜下腔和左侧半球枕叶也发现了出血。
我们建议，对于有发生缺氧高风险的胎儿，应进行超声评估，当发现颅内有回声时应考虑进行MRI检查。
