Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
Prenat Diagn. 2018 Aug;38(9):685-691. doi: 10.1002/pd.5296. Epub 2018 Jun 21.
To review fetal MRI cases surgically proven to have meconium ileus (MI) and obstruction, describe the common fetal MRI findings that distinguish cases of complicated MI, and to compare these findings with surgical images and perinatal outcomes.
We performed a retrospective review of all fetal MRI examinations and the corresponding medical record from our tertiary care children's hospital over an 18-month period. Postnatal management and outcomes were reviewed for these patients, and those patients with surgical or postmortem diagnosis of complicated MI were included in the study.
Our analysis revealed 7 cases. In this cohort, 3 imaging features of the fetal bowel were repeatedly seen: gradient appearance of intraluminal bowel contents, abnormally localized meconium signal, and collapsed appearance of the colon on MRI. Surgical diagnoses confirmed MI. All live-born infants underwent surgical repair.
Fetal MRI should be included in the diagnostic algorithm of any pregnancy where fetal bowel obstruction is suspected to better risk stratify patients.
回顾经手术证实患有胎粪性肠梗阻（MI）和梗阻的胎儿 MRI 病例，描述鉴别复杂 MI 病例的常见胎儿 MRI 表现，并将这些表现与手术图像和围产期结局进行比较。
我们对 18 个月期间在我们的三级儿童保健医院进行的所有胎儿 MRI 检查和相应的病历进行了回顾性分析。对这些患者进行了产后管理和结局的回顾，并且对那些具有复杂 MI 的手术或尸检诊断的患者进行了研究。
我们的分析显示了 7 例病例。在该队列中，反复出现胎儿肠管的 3 种影像学特征：肠腔内内容物的梯度外观、异常定位的胎粪信号和 MRI 上结肠的塌陷外观。手术诊断证实为 MI。所有活产婴儿均接受了手术修复。
对于怀疑胎儿肠阻塞的任何妊娠，都应将胎儿 MRI 纳入诊断算法中，以更好地对患者进行风险分层。
