Hyde Georgia, Fry Andrew, Raghavan Ashok, Whitby Elspeth
Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield, Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, United Kingdom.
Medical Imaging and Medical Physics, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Beech Hill Road, S10 2JF, Sheffield, United Kingdom.
BJR Open. 2020 Aug 5;2(1):20200032. doi: 10.1259/bjro.20200032. eCollection 2020.
Foetal MRI is used to assess abnormalities after ultrasonography. Bowel anomalies are a significant cause of neonatal morbidity, however there are little data concerning its normal appearance on antenatal MRI. This study aims to investigate the pattern of meconium accumulation throughout gestation using its hyperintense appearance on weighted scans and add to the current published data.
This was a retrospective cohort study in a tertiary referral clinical MRI centre. Foetal body MRI scans of varying gestational ages were obtained dating between October 2011 and March 2018. The bowel was visualised on weighted images. The length of the meconium and the width of the meconium at the rectum, sigmoid colon, splenic flexure and hepatic flexure was measured. Presence or absence of meconium in the small bowel was noted. Inter- and intrarater reliability was assessed.
181 foetal body scans were reviewed. 52 were excluded and 129 analysed. Visualisation of the meconium in the large bowel became increasingly proximal with later gestations, and small bowel visualisation was greater at earlier gestations. There was statistically significant strong ( = 0.6-0.8) or very strong ( = 0.8-1.0) positive correlation of length and width with increasing gestation. Interrater reliability was moderate to excellent ( = 0.4-1.0).
This study provides new information regarding the pattern of meconium accumulation throughout gestation. With care, the results can be used in clinical practice to aid diagnosis of bowel pathology.
The findings of this study provide further information concerning the normal accumulation of foetal meconium on MR imaging, an area where current research is limited.
胎儿磁共振成像（MRI）用于超声检查后评估异常情况。肠道异常是新生儿发病的重要原因，然而关于其在产前MRI上的正常表现的数据较少。本研究旨在利用加权扫描上胎粪的高信号表现，研究整个孕期胎粪积聚的模式，并补充当前已发表的数据。
这是一项在三级转诊临床MRI中心进行的回顾性队列研究。获取了2011年10月至2018年3月期间不同孕周的胎儿全身MRI扫描图像。在加权图像上观察肠道。测量胎粪的长度以及在直肠、乙状结肠、脾曲和肝曲处胎粪的宽度。记录小肠中是否存在胎粪。评估了评分者间和评分者内的可靠性。
对181例胎儿全身扫描图像进行了回顾。排除52例，分析129例。随着孕周增加，大肠中胎粪的可视化越来越靠近近端，而在较早孕周时小肠的可视化程度更高。长度和宽度与孕周增加呈统计学上显著的强（=0.6 - 0.8）或非常强（=0.8 - 1.0）正相关。评分者间可靠性为中度至优秀（=0.4 - 1.0）。
本研究提供了关于整个孕期胎粪积聚模式的新信息。谨慎使用的话，这些结果可用于临床实践以辅助肠道病变的诊断。
本研究结果提供了关于胎儿胎粪在磁共振成像上正常积聚的进一步信息，这是当前研究有限的一个领域。
