Frates Mary C, Kumar Ada J, Benson Carol B, Ward Valerie L, Tempany Clare M
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Radiology. 2004 Aug;232(2):398-404. doi: 10.1148/radiol.2322030504.
To compare prenatal ultrasonography (US) and magnetic resonance (MR) imaging for the diagnosis of fetal anomalies.
Images of 27 fetuses (28 diagnostic cases) with anomalies diagnosed at US were evaluated; in these fetuses, prenatal MR imaging was performed within 15 days of US. Prenatal US and MR imaging findings were compared with postnatal diagnoses. Postnatal evaluation included US, MR imaging, autopsy, surgery, voiding cystourethrography, computed tomography, angiography, and physical examination.
In seven diagnostic cases, US and MR imaging findings were in complete agreement with postnatal diagnoses. MR imaging correctly provided additional information to the US-determined diagnosis in another seven and correctly changed the US diagnosis in three. The MR imaging-determined diagnosis was incorrect and the US diagnosis was correct in four cases. In seven cases, the diagnoses at both US and MR imaging were incorrect when correlated with the postnatal outcome. MR imaging was most valuable in the assessment of anomalies of the central nervous system.
MR imaging may have a place as an adjunct to US in evaluation of fetal anomalies, particularly those involving the central nervous system.
比较产前超声检查(US)和磁共振成像(MR)对胎儿异常的诊断价值。
对27例经超声诊断为胎儿异常的胎儿(28个诊断病例)的图像进行评估;这些胎儿在超声检查后15天内接受了产前磁共振成像检查。将产前超声和磁共振成像检查结果与产后诊断结果进行比较。产后评估包括超声检查、磁共振成像检查、尸检、手术、排尿性膀胱尿道造影、计算机断层扫描、血管造影和体格检查。
在7个诊断病例中,超声和磁共振成像检查结果与产后诊断完全一致。磁共振成像在另外7个病例中正确地为超声确定的诊断提供了额外信息,并在3个病例中正确地改变了超声诊断。4个病例中磁共振成像确定的诊断错误而超声诊断正确。在7个病例中,与产后结果相关时,超声和磁共振成像的诊断均错误。磁共振成像在评估中枢神经系统异常方面最有价值。
磁共振成像作为超声的辅助手段,在评估胎儿异常,尤其是涉及中枢神经系统的异常方面可能有一定作用。