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单纯脑室扩大病例中胎儿脑 MRI 第三孕期检查的附加价值。

The added value of third trimester fetal brain MRI in cases of isolated ventriculomegaly.

机构信息

Department of Obstetrics and Gynecology, Samson Assuta Ashdod University Hospital, Ashdod, Israel.

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

J Matern Fetal Neonatal Med. 2022 Dec;35(25):6759-6763. doi: 10.1080/14767058.2021.1922379. Epub 2021 May 9.

Abstract

OBJECTIVES

To assess the added value of third trimester fetal brain MRI, performed in one tertiary referral center, in cases of isolated ventriculomegaly as established by a dedicated multiplanar neurosonography.

METHODS

Fetal brain MRI scans performed in a single tertiary center during a 3-year period were assessed for possible inclusion. Only cases diagnosed with ventriculomegaly without additional findings in a neurosonography preceding the MRI were included. Fetal MRI was performed at a median gestational of 32 weeks (IQR 31-34 weeks).

RESULTS

A total of 68 cases met the inclusion criteria. Of them, in four cases MRI identified additional findings including three cases of intraventricular hemorrhage and one case of cortical infarction. The overall rate of MRI-findings in the study population was (5.9%, 95% CI 2.3-14.2%). No additional findings were detected in cases of mild ventriculomegaly, 6.1% in moderate and 25% in severe ventriculomegaly. The combined rate of additional findings in mild to moderate ventriculomegaly was 3.3% (95%CI 0.9-11.4%).

CONCLUSIONS

MRI was able to detect additional findings in 5.9% of cases with seemingly isolated ventriculomegaly after a dedicated neurosonography. The severity of ventriculomegaly is associated with a higher chance of detecting abnormalities in fetal brain MRI.

摘要

目的

评估在专门的多平面神经超声检查确定为孤立性脑室扩大的情况下,在一家三级转诊中心进行的第三 trimester 胎儿脑 MRI 的附加价值。

方法

评估了在 3 年期间在单个三级中心进行的胎儿脑 MRI 扫描,以确定是否可能入选。仅包括在 MRI 前的神经超声检查中诊断为脑室扩大且无其他发现的病例。胎儿 MRI 检查在中位妊娠 32 周(IQR 31-34 周)进行。

结果

共有 68 例符合纳入标准。其中,在 4 例 MRI 中发现了其他发现,包括 3 例脑室出血和 1 例皮质梗死。在研究人群中,MRI 发现的总体发生率为(5.9%,95%CI 2.3-14.2%)。轻度脑室扩大的病例未发现其他异常,中度脑室扩大的病例为 6.1%,重度脑室扩大的病例为 25%。轻度至中度脑室扩大的合并发现率为 3.3%(95%CI 0.9-11.4%)。

结论

在专门的神经超声检查后,MRI 能够在 5.9%的似乎孤立性脑室扩大病例中检测到其他异常。脑室扩大的严重程度与在胎儿脑 MRI 中检测到异常的几率更高相关。

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