School of Medicine, Shandong University, Jinan, China.
Shandong Medical Imaging Research Institute, Shandong University, Jinan, China.
Prenat Diagn. 2019 Sep;39(10):883-889. doi: 10.1002/pd.5499. Epub 2019 Jul 23.
This study aims to evaluate the accuracy of magnetic resonance imaging (MRI) in diagnosing orofacial clefts and proposes specific signs for determining the type of cleft.
Pregnant women in whom fetal facial malformations are suspected by ultrasonography (US) underwent 1.5 T MRI. The accuracy of the prenatal US and MRI diagnosis was compared with the postnatal findings.
A total of 71 fetuses were included in the final analysis, which comprised of 35 cases of isolated cleft lip, six cases of cleft lip and alveolus, 21 cases of cleft lip and palate, four cases of isolated cleft palate, and five normal fetuses. MRI was more sensitive than US (MRI 100%, US 77.5%; Fisher's exact test: MRI vs US P=0.000). The accuracy of MRI for all types was 100%. Specific signs (Inverted T, L/anti-L, U, and "Notch" signs) were proposed, indicating the normal hard, unilateral cleft, bilateral cleft, and cleft soft palates, respectively, which can facilitate the identification of different types of cleft palates.
MRI can accurately diagnose the type of cleft based on typical signs, which can serve as a definite diagnostic modality and an effective supplement of US.
本研究旨在评估磁共振成像（MRI）在诊断口腔面裂中的准确性，并提出用于确定裂隙类型的特定征象。
对经超声（US）检查怀疑胎儿面部畸形的孕妇行 1.5T MRI 检查。比较产前 US 和 MRI 诊断的准确性与产后发现。
最终共有 71 例胎儿纳入最终分析，其中包括单纯唇裂 35 例、唇裂合并牙槽裂 6 例、唇裂合并腭裂 21 例、单纯腭裂 4 例和正常胎儿 5 例。MRI 比 US 更敏感（MRI 为 100%，US 为 77.5%；Fisher 确切检验：MRI 与 US，P=0.000）。MRI 对所有类型的准确性为 100%。提出了特定征象（倒置 T 形、L/反 L 形、U 形和“缺口”征），分别提示正常硬腭、单侧裂隙、双侧裂隙和腭裂软腭，有助于识别不同类型的腭裂。
MRI 可基于典型征象准确诊断裂隙类型，可作为明确的诊断方式，也是 US 的有效补充。
