Li Zhi, Zhu Ming, Dong Suzhen, Luo Zhiqin, Fei Zhenghua, Fang Xiangming, Qi Linghong
Department of Radiology, Huzhou Maternity and Child Care Hospital, Huzhou 313000, China.
Zhonghua Fu Chan Ke Za Zhi. 2016 Jan;51(1):23-6. doi: 10.3760/cma.j.issn.0529-567X.2016.01.006.
To investigate the clinical value of prenatal MRI in the diagnosis and differential diagnosis of congenital bronchopulmonary sequestration (BPS).
From January 2009 to December 2014, 16 fetuses with BPS were diagnosed by fetal MRI in Huzhou Maternity and Child Care Hospital and Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine. The clinical data of these cases were analyzed retrospectively. All were singleton pregnancy, and MRI was carried out within 24-48 hours after routine prenatal ultrasound. All the neonates underwent postnatal enhanced CT scan or surgical biopsy after birth, and the results were compared to prenatal MRI diagnosis.
(1) With prenatal MRI, 16 cases were diagnosed BPS. The lesions located in left lung in 10 cases, and right lung in 6 cases. As the scope of the lesion, 3 cases located in the whole left lung, 6 cases limited to the left lower lobe, and 1 case was subdiaphragmatic on the left side. 2 cases located in the whole right lung and 4 cases limited to the right lower lobe. One case complicated oligoamnios, and one had pleural effusion. Supplying vessels could be found in 14 cases. (2) When the postnatal results were compared with prenatal MRI, 15 cases were comfirmed as BPS (15/16), including 10 intralobar cases 5 extralobar cases. One that was diagnosed as BPS by prenatal MRI was confirmed to be congenital cystic adenomatoid malformation (CCAM) by pathology. The accuracy of prenatal MRI diagnosis of BPS was 15/16. Prenatal ultrasound missed one case and misdiagnosed two cases, as one was mistakened as CCAM and the other as cystic teratoma.
Prenatal MRI has good clinical value in the diagnosis and differential diagnosis of fetal BPS.
探讨产前磁共振成像（MRI）在先天性肺隔离症（BPS）诊断及鉴别诊断中的临床价值。
回顾性分析2009年1月至2014年12月期间，在湖州市妇幼保健院及上海交通大学医学院附属上海儿童医学中心通过胎儿MRI诊断为BPS的16例胎儿的临床资料。所有病例均为单胎妊娠，在常规产前超声检查后24 - 48小时内行MRI检查。所有新生儿出生后均接受增强CT扫描或手术活检，并将结果与产前MRI诊断结果进行比较。
（1）产前MRI诊断BPS 16例。病变位于左肺10例，右肺6例。按病变范围，3例位于左全肺，6例局限于左肺下叶，1例位于左侧膈下。2例位于右全肺，4例局限于右肺下叶。1例合并羊水过少，1例有胸腔积液。14例可发现供血血管。（2）将产后结果与产前MRI比较，15例确诊为BPS（15/16），其中叶内型10例，叶外型5例。1例产前MRI诊断为BPS，病理确诊为先天性囊性腺瘤样畸形（CCAM）。产前MRI诊断BPS的准确率为15/16。产前超声漏诊1例，误诊2例，1例误诊为CCAM，另1例误诊为囊性畸胎瘤。
产前MRI在胎儿BPS的诊断及鉴别诊断中具有良好的临床价值。
