Centre Pluridisciplinaire de Diagnostic Prénatal, Hopital Timone Enfants, Assistance Publique Hôpitaux de Marseille AP-HM, Aix Marseille Université AMU, France.
Unité de dépistage et de diagnostic prénatal, Hôpital Privé Marseille Beauregard, Marseille, France.
Prenat Diagn. 2022 Apr;42(4):502-511. doi: 10.1002/pd.6123. Epub 2022 Mar 7.
To assess the contribution and impact of fetal magnetic resonance imaging (MRI) in managing fetal gastroschisis.
We conducted an observational retrospective study of gastroschisis patients at three fetal medicine centers from 2008 to 2019. The primary endpoint was the number of cases in which the MRI provided relevant information related to gastroschisis.
A total of 189 patients were included, and our study group included 38 patients who underwent MRI. For the eight patients with suspected gastroschisis, MRI confirmed the diagnosis. In six cases, it provided additional relevant information (spiral turn, intestine ischemia, and bowel size discrepancy). For the 17 patients with ultrasound signs of additional gastrointestinal anomalies, MRI detected one case of unidentified complex gastroschisis on sonography. For the 13 patients undergoing routine MRI, no significant information was obtained. One termination of pregnancy and one fetoscopy were performed a few days after the MRI results. There was no subsequent follow-up or additional bowel complications to support management.
Although MRI did not change the management of pregnancies complicated by fetal gastroschisis, patients presenting with fetal gastroschisis with intraabdominal bowel dilatation could benefit from MRI to allow for more precise prenatal counseling to predict postnatal intestinal complications before birth.
评估胎儿磁共振成像（MRI）在胎儿脐膨出治疗中的作用和影响。
我们对 2008 年至 2019 年期间三家胎儿医学中心的脐膨出患者进行了一项观察性回顾性研究。主要终点是 MRI 提供与脐膨出相关的相关信息的病例数。
共纳入 189 例患者，本研究组包括 38 例行 MRI 的患者。对于 8 例疑似脐膨出的患者，MRI 证实了诊断。在 6 例中，它提供了额外的相关信息（螺旋旋转、肠缺血和肠大小差异）。对于 17 例超声提示存在其他胃肠道异常的患者，MRI 在超声上未识别出复杂的脐膨出。对于 13 例行常规 MRI 的患者，未获得明显信息。在 MRI 结果后几天进行了一次终止妊娠和一次胎儿镜检查。没有进一步的随访或额外的肠道并发症支持治疗。
尽管 MRI 并未改变胎儿脐膨出合并妊娠的处理方式，但对于存在腹腔内肠扩张的胎儿脐膨出患者，MRI 可能有助于更精确的产前咨询，以预测出生前的肠道并发症。
