Carcopino Xavier, Chaumoitre Kathia, Shojai Raha, Akkawi Reem, Panuel Michel, Boubli Léon, D'ercole Claude
Departments of Obstetrics and Gynaecology, Hôpital Nord, Chemin des Bourrellys, 13915 Cedex 20 Marseille, France.
Prenat Diagn. 2007 Mar;27(3):272-8. doi: 10.1002/pd.1666.
To evaluate how foetal magnetic resonance imaging (MRI) may change the diagnosis in cases of ultrasound (U/S) findings of echogenic bowel (EB).
Seventeen foetuses with EB underwent serial U/S examinations, foetal MRI, cystic fibrosis screening and maternal viral serologic tests. MRI protocol included T2-weighted half-Fourier acquired single-shot turbo spin-echo (HASTE) sequence and gradient echo (GE) T1-weighted images. Foetal abdominal MRI analyzed patterns were size and signal of small bowel, colon and rectum, ascites and abdominal mass. All neonates had complete clinical examination, abdominal sonography, and a 6 months clinical follow-up.
Eleven foetuses with isolated EB had normal MRI and normal outcome. In comparison, all the 6 foetuses whose U/S patterns showed associated signs had abnormal MRI (p < 0.001). Five had proven pathology (83.3%: 5/6) and only 1 (16.7%: 1/6) had no proven pathology and normal postnatal outcome (p = 0.001). For those five, foetal MRI showed bowel abnormalities with one case of bowel duplication and four cases of bowel obstruction. Two out of the four cases of bowel obstruction were genetically diagnosed as cystic fibrosis. The two remaining cases were diagnosed as ileal atresia.
MRI could provide additive information in cases of EB associated with bowel dilatation.
评估胎儿磁共振成像（MRI）如何改变超声（U/S）检查发现的胎儿肠回声增强（EB）病例的诊断结果。
17例患有EB的胎儿接受了系列超声检查、胎儿MRI检查、囊性纤维化筛查及母体病毒血清学检测。MRI检查方案包括T2加权半傅里叶采集单次激发快速自旋回波（HASTE）序列和梯度回波（GE）T1加权图像。对胎儿腹部MRI分析的模式包括小肠、结肠和直肠的大小及信号、腹水和腹部肿块。所有新生儿均进行了全面的临床检查、腹部超声检查，并进行了6个月的临床随访。
11例孤立性EB胎儿的MRI检查结果正常，预后良好。相比之下，6例超声检查显示有相关体征的胎儿的MRI检查结果均异常（p < 0.001）。5例确诊有病理改变（83.3%：5/6），仅1例（16.7%：1/6）未确诊有病理改变且出生后预后良好（p = 0.001）。对于这5例，胎儿MRI显示肠道异常，其中1例为肠道重复畸形，4例为肠梗阻。4例肠梗阻病例中有2例经基因诊断为囊性纤维化。其余2例诊断为回肠闭锁。
对于合并肠扩张的EB病例，MRI可提供补充信息。
