Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.
Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.
Arch Gynecol Obstet. 2022 Apr;305(4):877-884. doi: 10.1007/s00404-021-06210-8. Epub 2021 Aug 30.
The aim of the study was to compare the magnetic resonance imaging (MRI) findings of intracranial haemorrhage (ICH) in the middle- and late trimesters and to explore the relationship between the MRI features of foetal ICH and postnatal outcomes.
This was a retrospective study which recruited foetal ICH diagnosed by MRI in one tertiary centre from 2015 to 2019. The prenatal and postnatal medical records were reviewed.
Of 39 ICH cases, 82.1% (32) had germinal matrix intraventricular haemorrhage (GM-IVH), and 18.9% (7) were diagnosed with non-GM-IVH. The cerebellum, corpus callosum and subdural space were affected in 5, 1 and 1 non-GM-IVH cases, respectively. MRI confirmed possible ICH on sonogram in 10 cases (35.7%) and the remaining 19 added ICH diagnoses that were not obtained on initial ultrasound imaging. Pregnancy outcome data were available in 82.1% of (32) cases, of which 21 were terminated pregnancies, 1 was foetal demise and 10 were delivered. One neonate died after birth and one infant suffered from hearing loss. The remaining eight patients had favourable outcome.
In our study, evaluation of the relationship between MRI findings and outcomes remains challenging, depending on the timing of examination and the hematoma itself. MRI was an adjunct to US in diagnosing ICH in utero which helps to assess postnatal development.
本研究旨在比较中晚期胎儿颅内出血（ICH）的磁共振成像（MRI）表现，并探讨胎儿 ICH 的 MRI 特征与产后结局的关系。
这是一项回顾性研究，纳入了 2015 年至 2019 年期间在一家三级中心通过 MRI 诊断的胎儿 ICH 病例。回顾了产前和产后的病历记录。
39 例 ICH 病例中，82.1%（32 例）为脑室内出血（GM-IVH），18.9%（7 例）为非 GM-IVH。5 例非 GM-IVH 分别累及小脑、胼胝体和硬膜下腔。10 例（35.7%）MRI 证实了超声检查可能的 ICH，其余 19 例则增加了初始超声检查未发现的 ICH 诊断。82.1%（32 例）病例的妊娠结局数据可用，其中 21 例终止妊娠，1 例胎儿死亡，10 例分娩。1 例新生儿出生后死亡，1 例婴儿听力损失。其余 8 例患者预后良好。
在本研究中，MRI 检查结果与结局之间的关系评估取决于检查时机和血肿本身，具有一定的挑战性。MRI 是产前诊断 ICH 的超声检查的辅助手段，有助于评估产后发育情况。
