Hung Yun-Hsiang, Tsai Ching-Chang, Ou Chia-Yu, Cheng Bi-Hua, Yu Pao-Chu, Hsu Te-Yao
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung, Taiwan.
Taiwan J Obstet Gynecol. 2008 Mar;47(1):79-83. doi: 10.1016/S1028-4559(08)60059-5.
Prenatal diagnosis of a cloacal anomaly is difficult. Magnetic resonance imaging (MRI) can assist in the identification of the connection and continuity of a cystic mass to confirm the diagnosis of a cloacal anomaly.
In the first case, a fetal abdominal cystic mass was observed at 32 weeks of gestation. Ultrasonography revealed a retrovesical septate hypoechoic mass with bilateral hydronephrosis. MRI demonstrated a midline cystic mass connected to a dilated uterus and a possible fistula between the bladder and vagina. In the second case, a fetal abdominal septate cystic mass was identified using ultrasonography at 34 weeks of gestation. MRI was performed and demonstrated hydrocolpos/hydrometrocolpos originating from a uterine didelphis with left dysgenesis and a possible vesicovaginal fistula. After birth, both newborns underwent immediate surgical intervention with good outcomes.
MRI facilitated the prenatal diagnosis of cloacal anomalies and allowed additional time for parental counseling and planning of the delivery method with subsequent neonatal intensive care and surgical and urologic consultations.
泄殖腔畸形的产前诊断较为困难。磁共振成像（MRI）有助于识别囊性肿物的连接和连续性，以确诊泄殖腔畸形。
第一例中，在妊娠32周时观察到胎儿腹部有一囊性肿物。超声检查显示膀胱后有一分隔的低回声肿物，伴有双侧肾积水。MRI显示一位于中线的囊性肿物与扩张的子宫相连，膀胱与阴道之间可能存在瘘管。第二例中，在妊娠34周时通过超声检查发现胎儿腹部有一分隔的囊性肿物。进行MRI检查显示为双子宫左侧发育不全所致的阴道积血/子宫阴道积血，且可能存在膀胱阴道瘘。出生后，两名新生儿均立即接受了手术干预，效果良好。
MRI有助于泄殖腔畸形的产前诊断，并为父母咨询、分娩方式规划以及随后的新生儿重症监护、外科和泌尿外科会诊留出了更多时间。
