Department of Diagnostic and Interventional Imaging, KK Womens' and Childrens' Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Abdom Radiol (NY). 2021 Jul;46(7):3365-3377. doi: 10.1007/s00261-021-03031-w. Epub 2021 Mar 13.
Intrauterine fetal demise (IUFD) is an uncommon but serious event that may occasionally be encountered on fetal MRI. Compared to the more florid signs of fetal demise which has occurred some time ago, recent IUFD is associated with more subtle findings that may be missed or misinterpreted. The two main MRI sequences used in imaging the fetus are T2-like two-dimensional balanced steady-state free-precession (SSFP), a white blood sequence, or T2-weighted single-shot fast spin-echo (SSFSE), a black blood sequence. The most reliable and specific signs of a recent IUFD are a constricted heart with poorly delineated cardiac chambers and signal abnormality in the heart and aorta, which will have different features depending on the MRI sequence used. Secondary signs of IUFD include global brain ischemia, abnormal globes, effusions, body wall edema and umbilical cord thrombosis. Unlike fetal ultrasound examinations where cardiac activity is routinely assessed, fetal MRI requires careful scrutiny of the fetal heart for assessment of fetal life.
胎儿宫内死亡（IUFD）是一种不常见但严重的事件，在胎儿 MRI 上偶尔会遇到。与以前发生的更明显的胎儿死亡迹象相比，最近的 IUFD 与更微妙的发现有关，这些发现可能会被遗漏或误解。用于胎儿成像的两种主要 MRI 序列是 T2 样二维平衡稳态自由进动（SSFP），即白血序列，或 T2 加权单次快速自旋回波（SSFSE），即黑血序列。最近 IUFD 的最可靠和特异的征象是心脏狭窄，心腔轮廓不清，心脏和主动脉信号异常，这将根据使用的 MRI 序列而具有不同的特征。IUFD 的次要征象包括全脑缺血、眼球异常、积液、腹壁水肿和脐带血栓形成。与胎儿超声检查中常规评估心脏活动不同，胎儿 MRI 需要仔细检查胎儿心脏以评估胎儿生命。
