Liu Cai-Xia, Yin Shao-Wei, Chen Jing
Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
Zhonghua Fu Chan Ke Za Zhi. 2008 Sep;43(9):666-9.
To evaluate the diagnostic value of MRI in the cases suspected of ventriculomegaly by prenatal ultrasonography.
104 patients of suspected fetal ventriculomegaly (VM) diagnosed by ultrasonography were included from the Shengjing Hospital, China Medical University from March 2006 to October 2007. All cases were divided into 4 groups based on the standard of Gaglioti: 10 - 12 mm (66 cases), 13 - 15 mm (22 cases), 16 - 20 mm (14 cases), and 21 - 25 mm (2 cases); they included 75 cases of single intracerebroventricular expansion and 29 cases of double intracerebroventricular expansion. All of them were subjected to MRI scan within 48 h of ultrasonographic examination to determine the prenatal diagnosis by MRI pregnancy outcomes.
Among the 26 072 cases who received prenatal ultrasonography, 104 cases (0.39%) were VM. (1) MRI detected 3 cases (5%) in 10 - 12 mm group: one case of cerebellar hypoplasia, vascular malformation, chest and abdominal anomalies each; 5 cases (23%) in 13 - 15 mm group: one case of agenesis of corpus callosum (ACC), cerebral hemorrhage, cerebral hemorrhage with cerebral meningocele, cerebral meningocele, intracranial mass meningocele each; 6 cases(43%)in 16 - 20 mm group: 4 cases of ACC, one case of intraventricular hemorrhage and ACC combined with ventricular hemorrhage each; 2 cases in 21 - 25 mm group: one case of ACC and intraventricular hemorrhage each. (2) MRI detected 4 cases (5%) among 75 unilateral VM cases and 12 cases (41%) among 29 bilateral VM cases. The differences were significant (P < 0.01). MRI diagnosis rate was 15.38% (16 cases). Follow-up of the outcomes of the pregnancy showed induction of labor in 15 cases (14%) all of which were the same as MRI results on autopsy, full-term delivery of 88 cases, of which all the neonates were healthy.
When the expansion width is above 16 mm or bilateral VM is suspected by ultrasonography, we suggest MRI examination to determine fetal central nervous system disease.
评估磁共振成像（MRI）对产前超声怀疑脑室扩大病例的诊断价值。
选取2006年3月至2007年10月在中国医科大学附属盛京医院就诊的104例经超声诊断怀疑胎儿脑室扩大（VM）的患者。所有病例根据加廖蒂标准分为4组：10 - 12毫米（66例）、13 - 15毫米（22例）、16 - 20毫米（14例）和21 - 25毫米（2例）；其中单脑室扩张75例，双脑室扩张29例。所有患者在超声检查后48小时内接受MRI扫描，以通过MRI确定产前诊断及妊娠结局。
在26072例接受产前超声检查的病例中，104例（0.39%）为VM。（1）MRI在10 - 12毫米组中检测出3例（5%）：小脑发育不全、血管畸形、胸腹部畸形各1例；在13 - 15毫米组中检测出5例（23%）：胼胝体发育不全（ACC）、脑出血、脑出血合并脑膨出、脑膨出、颅内肿物性脑膨出各1例；在16 - 20毫米组中检测出6例（43%）：ACC 4例，脑室出血、ACC合并脑室出血各1例；在21 - 25毫米组中检测出2例：ACC和脑室出血各1例。（2）MRI在75例单侧VM病例中检测出4例（5%），在29例双侧VM病例中检测出12例（41%）。差异有统计学意义（P < 0.01）。MRI诊断率为15.38%（16例）。对妊娠结局进行随访，15例（14%）引产，尸检结果均与MRI结果一致；88例足月分娩，所有新生儿均健康。
当超声检查显示扩张宽度大于16毫米或怀疑为双侧VM时，建议进行MRI检查以确定胎儿中枢神经系统疾病。
