Zhang Ying-hua, Wang Guang-bin, Ma Yu-xiang
Department of Medical Imaging, School of Medicine, Shandong University, Jinan 250012, China.
Zhonghua Fu Chan Ke Za Zhi. 2010 Mar;45(3):174-8.
To compare the value of ultrasound and magnetic resonance imaging (MRI) in detecting fetal spine and spinal cord dysplasia.
Thirty women with complicated pregnancies, age from 22 to 41 years, gestation from 23-38 weeks, were studied with MRI within 72 hours after ultrasound studies and revealed 19 cases of fetal spine with irregular, 7 cases of vertebral canal widened partly and 4 cases of anomalies of spinal curvature. Autopsy or imaging was conducted when pregnancy was terminated. A close follow-up was given for cases continuing pregnancy within 12 months after delivery.
(1) Nineteen cases of fetal spine with irregular in ultrasound, the coincidence of antenatal sonographic diagnosis was 42% (8/19), the coincidence of antenatal MRI diagnosis was 89% (17/19). Seven cases of vertebral canal widened partly in ultrasound, the coincidence of antenatal sonographic diagnosis was 0, the coincidence of antenatal MRI diagnosis was 7/7. Four cases of anomalies of spinal curvature in ultrasound, the coincidence of antenatal sonographic diagnosis was 2/4, the coincidence of antenatal MRI diagnosis was 3/4.(2) By MRI study, one cases were conformed their ultrasound diagnosis, eleven cases were completed their ultrasound diagnosis, nine cases were made the same diagnosis as ultrasound and six cases were corrected diagnosis. By MRI and ultrasound study one case of hemivertebra, one case of butterfly vertebra and one case of dorsal dermal sinus were missed diagnosis. Ultrasound had limits and low specificity especially in fetal spinal cord.
MRI can show the spinal cord and its lesion intuitively and has advantages in displaying fetal anomaly of spine and spinal cord. MRI is a valuable complement to sonography in difficult cases and diagnostic accuracy can be significantly improved.
比较超声与磁共振成像（MRI）在检测胎儿脊柱和脊髓发育异常中的价值。
选取30例妊娠合并症孕妇，年龄22至41岁，孕周23 - 38周，在超声检查后72小时内接受MRI检查，发现19例胎儿脊柱形态不规则、7例椎管部分增宽、4例脊柱曲度异常。终止妊娠时进行尸检或影像学检查。对分娩后12个月内继续妊娠的病例进行密切随访。
（1）超声检查发现19例胎儿脊柱形态不规则，产前超声诊断符合率为42%（8/19），产前MRI诊断符合率为89%（17/19）。超声检查发现7例椎管部分增宽，产前超声诊断符合率为0，产前MRI诊断符合率为7/7。超声检查发现4例脊柱曲度异常，产前超声诊断符合率为2/4，产前MRI诊断符合率为3/4。（2）通过MRI检查，1例证实超声诊断，11例完善超声诊断，9例与超声诊断相同，6例纠正诊断。通过MRI和超声检查，1例半椎体、1例蝴蝶椎和1例背部皮样囊肿漏诊。超声检查存在局限性且特异性低，尤其是在胎儿脊髓方面。
MRI能直观显示脊髓及其病变，在显示胎儿脊柱和脊髓异常方面具有优势。在疑难病例中，MRI是超声检查的重要补充，可显著提高诊断准确性。
