Girard Nadine J
Department of Neuroradiology, Timone Hospital; and UMR 6612, CRMBM, Faculté de Médecine, Université de la Méditerranée, Marseille, France.
Top Magn Reson Imaging. 2011 Feb;22(1):11-23. doi: 10.1097/RMR.0b013e3182425bb2.
Fetal developmental anomalies consist of central nervous system malformations, brain injury, and tumors. Overlap is often seen especially between malformation and injury because malformation may be genetically determined or related to external causative agent, whereas brain injury may be, on one hand, caused by malformation as with intracranial vascular malformation and, on another, can cause brain malformation when cerebral insult occurs during organogenesis and histogenesis. The goal of this review was not to describe by magnetic resonance imaging (MRI) all fetal developmental anomalies encountered in utero; it is most likely to focus on fetal brain anomalies that either are most commonly seen in fetal tertiary care facility or are extremely challenging for MRI. Consequently, the potential of advanced MR techniques such as proton MR spectroscopy and diffusion tensor imaging is also described especially when a challenge is highlighted. This review is therefore organized in subchapters as follows. The first section gives the place of MRI in prenatal development and cites the standard protocol and the advanced techniques. The rules of fetal brain MRI, the challenge and pitfalls, and the selection of MRI cases follow as 3 subchapters. Also, abnormalities are described as 3 separate subchapters entitled ventriculomegalies (hydrocephalus), malformations, and brain injury.
胎儿发育异常包括中枢神经系统畸形、脑损伤和肿瘤。畸形与损伤之间常常存在重叠，尤其是畸形与损伤之间，因为畸形可能由基因决定或与外部致病因素有关，而脑损伤一方面可能由畸形引起，如颅内血管畸形，另一方面在器官发生和组织发生过程中发生脑损伤时也可导致脑畸形。本综述的目的不是通过磁共振成像（MRI）描述子宫内遇到的所有胎儿发育异常；它很可能侧重于在胎儿三级护理机构中最常见或对MRI极具挑战性的胎儿脑异常。因此，还特别描述了诸如质子磁共振波谱和扩散张量成像等先进MR技术的潜力，尤其是在突出挑战的情况下。因此，本综述按以下子章节进行组织。第一部分介绍了MRI在产前发育中的地位，并引用了标准方案和先进技术。胎儿脑MRI的规则、挑战与陷阱以及MRI病例的选择作为3个子章节。此外，异常情况分为3个单独的子章节，分别为脑室扩大（脑积水）、畸形和脑损伤。
