Verhoye Marleen, Votino Carmela, Cannie Mieke M, Segers Valérie, Mabiglia Chiara, Cos Teresa, Lipombi Dominique, Jani Jacques C
Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium.
J Matern Fetal Neonatal Med. 2013 Jul;26(11):1060-5. doi: 10.3109/14767058.2013.767891. Epub 2013 Feb 14.
To evaluate image quality and diagnostic accuracy of high-field post-mortem (PM) magnetic resonance imaging (MRI) on fetuses below 20 weeks of gestation before and after the freeze-thaw process.
Nine fetuses were scanned with three different scanning procedures: "fresh", just after termination of pregnancy (TOP), "non-fresh short scan" and "non-fresh long scan" after being kept at -20 °C, followed by a conventional autopsy. The brain, thorax except the heart, heart and abdomen were studied. The qualities of the images for the four different fetal regions and for the three different scanning procedures were reported. Regression analysis was used to investigate the effect on image quality of different factors. Additionally, the diagnostic accuracy was also evaluated.
Fetuses at 12.0-19.6 weeks were included. Regression analysis showed that better image quality was correlated to advanced gestation at TOP and scan on fresh fetuses. PM-MRI on fresh fetuses was always diagnostic for the brain and in more than half of cases on non-fresh fetuses and was nearly equally diagnostic for thoracic and abdominal structures.
High-field PM-MRI seems to offer a quite reliable alternative to the parents declining conventional PM for fetuses before 20 weeks whether these fetuses are freshly scanned or after being frozen.
评估高场强死后(PM)磁共振成像(MRI)在冻融前后对妊娠20周以下胎儿的图像质量和诊断准确性。
对9例胎儿采用三种不同扫描程序进行扫描:妊娠终止后立即扫描的“新鲜”扫描、-20°C保存后的“非新鲜短扫描”和“非新鲜长扫描”,随后进行传统尸检。对脑、除心脏外的胸部、心脏和腹部进行研究。报告了四个不同胎儿区域以及三种不同扫描程序的图像质量。采用回归分析研究不同因素对图像质量的影响。此外,还评估了诊断准确性。
纳入12.0 - 19.6周的胎儿。回归分析表明,图像质量较好与妊娠终止时的孕周较大以及对新鲜胎儿进行扫描有关。新鲜胎儿的PM-MRI对脑总是具有诊断价值,对非新鲜胎儿在半数以上病例中具有诊断价值,对胸部和腹部结构的诊断价值几乎相同。
对于拒绝传统尸检的20周以下胎儿的父母而言,无论这些胎儿是新鲜扫描还是冷冻后扫描,高场强PM-MRI似乎提供了一种相当可靠的替代方法。