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产前磁共振成像中的母婴偶然发现。

Maternal and fetal incidental findings on antenatal magnetic resonance imaging.

机构信息

Department of Women and Children's Health, King's College London, 10th Floor North Wing, St. Thomas' Hospital, London, SE1 7EH, UK.

Fetal Medicine Unit, Guy's and St. Thomas' NHS Foundation Trust, London, UK.

出版信息

Pediatr Radiol. 2021 Sep;51(10):1839-1847. doi: 10.1007/s00247-021-05074-z. Epub 2021 May 27.

Abstract

BACKGROUND

Magnetic resonance imaging (MRI) examinations are increasingly used in antenatal clinical practice. Incidental findings are a recognized association with imaging and although in some circumstances their identification can alter management, they are often associated with increased anxiety, for both patient and clinician, as well as increased health care costs.

OBJECTIVE

This study aimed to evaluate the incidence of unexpected findings in both the mother and fetus during antenatal MRI examinations.

MATERIALS AND METHODS

A retrospective study was undertaken over a five-year period at St.. Thomas' Hospital in London. Maternal incidental findings were recorded from all clinical reports of all fetal MRIs performed (for clinical reasons and in healthy volunteers) during this period. Fetal incidental findings were recorded only in cases where women with uncomplicated pregnancies were participating as healthy volunteers.

RESULTS

A total of 2,569 MRIs were included; 17% of women had maternal incidental findings. Of these, 1,099 were women with uncomplicated pregnancies who undertook research MRIs as healthy volunteers; fetal incidental findings were identified in 12.3%.

CONCLUSION

Incidental findings are a common occurrence in antenatal MRI. Consideration should be given to counseling women appropriately before imaging and ensuring that robust local protocols are in place for follow-up and further management of such cases.

摘要

背景

磁共振成像(MRI)检查在产前临床实践中越来越多地被应用。偶然发现是与成像相关的一种公认的关联,尽管在某些情况下,它们的识别可以改变管理方式,但它们常常与患者和临床医生的焦虑增加以及医疗保健成本增加有关。

目的

本研究旨在评估产前 MRI 检查中母亲和胎儿意外发现的发生率。

材料和方法

在伦敦圣托马斯医院进行了一项为期五年的回顾性研究。从该期间进行的所有因临床原因和健康志愿者进行的胎儿 MRI 的所有临床报告中记录了母体偶然发现。只有在没有并发症的孕妇作为健康志愿者参与的情况下,才会记录胎儿偶然发现。

结果

共纳入 2569 例 MRI;17%的女性有母体偶然发现。其中,1099 例为接受研究性 MRI 的无并发症妊娠妇女,作为健康志愿者;胎儿偶然发现发生率为 12.3%。

结论

偶然发现是产前 MRI 中的常见现象。在进行影像学检查之前,应适当考虑对女性进行咨询,并确保有健全的本地方案用于此类病例的随访和进一步管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a50/8426300/5ec0b3cdea15/247_2021_5074_Fig1_HTML.jpg

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