Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Eur J Radiol. 2012 Feb;81(2):e115-22. doi: 10.1016/j.ejrad.2010.12.095. Epub 2011 Feb 12.
Fetal tumors can have a devastating effect on the fetus, and may occur in association with congenital malformations. In view of the increasing role of fetal magnetic resonance imaging (MRI) as an adjunct to prenatal ultrasonography (US), we sought to demonstrate the visualization of fetal tumors, with regard to congenital abnormalities, on MRI.
This retrospective study included 18 fetuses with tumors depicted on fetal MRI after suspicious US findings. An MRI standard protocol was used to diagnose tumors judged as benign or malignant. All organ systems were assessed for tumor-related complications and other congenital malformations. Available US results and histopathology were compared with MRI.
There were 13/18 (72.2%) benign and 5/18 (27.8%) malignant tumors diagnosed: a cerebral primitive neuroectodermal tumor in 1/18, head-neck teratomas in 4/18; ventricular rhabdomyomas in 4/18; a cardiac teratoma in 1/18; a hepatoblastoma in 1/18; neuroblastomas in 2/18; a cystic hemorrhagic adrenal hyperplasia in 1/18; a pelvic leiomyoma in 1/18; sacrococcygeal teratomas in 3/18. Tumor-related complications were present in 13/18 (72.2%) cases; other congenital abnormalities in 3/18 (16.7%). MRI diagnosis and histology were concordant in 8/11 (72.7%) cases. In 6/12 (50%) cases, US and MRI diagnoses were concordant, and, in 6/12 (50%) cases, additional MRI findings changed the US diagnosis.
Our MRI results demonstrate the visualization of fetal tumors, with frequently encountered tumor-related complications, and other exceptional congenital abnormalities, which may provide important information for perinatal management. Compared to prenatal US, MRI may add important findings in certain cases.
胎儿肿瘤可能对胎儿造成严重影响,并可能与先天性畸形有关。鉴于胎儿磁共振成像(MRI)作为产前超声(US)的辅助手段的作用越来越大,我们旨在展示 MRI 对胎儿肿瘤的可视化,以及与先天性异常有关的肿瘤。
本回顾性研究包括 18 例在可疑 US 结果后在胎儿 MRI 上显示肿瘤的胎儿。使用 MRI 标准方案诊断良性或恶性肿瘤。评估所有器官系统的肿瘤相关并发症和其他先天性畸形。将可用的 US 结果和组织病理学与 MRI 进行比较。
诊断出 13/18(72.2%)良性和 5/18(27.8%)恶性肿瘤:1/18 例大脑原始神经外胚层肿瘤、1/18 例头颈部畸胎瘤、4/18 例心室横纹肌瘤;1/18 例心脏畸胎瘤;1/18 例肝母细胞瘤;2/18 例神经母细胞瘤;1/18 例囊性出血性肾上腺增生;1/18 例骨盆平滑肌瘤;3/18 例骶尾部畸胎瘤。13/18(72.2%)例存在肿瘤相关并发症;3/18(16.7%)例存在其他先天性异常。MRI 诊断与组织学在 8/11(72.7%)例中一致。在 6/12(50%)例中,US 和 MRI 诊断一致,在 6/12(50%)例中,额外的 MRI 发现改变了 US 诊断。
我们的 MRI 结果显示了胎儿肿瘤的可视化,以及常见的肿瘤相关并发症和其他罕见的先天性异常,这可能为围产期管理提供重要信息。与产前 US 相比,MRI 在某些情况下可能会提供重要发现。