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胎儿磁共振成像与超声检查诊断胎儿脊柱和脊髓先天畸形的准确性比较。

A comparison of the accuracy of fetal magnetic resonance imaging and ultrasonography for the diagnosis of fetal congenital malformations of the spine and spinal cord.

机构信息

Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.

Department of Clinical Laboratory, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.

出版信息

Prenat Diagn. 2022 Sep;42(10):1295-1302. doi: 10.1002/pd.6209. Epub 2022 Jul 20.

Abstract

PURPOSE

To determine the diagnostic value of fetal magnetic resonance imaging (MRI) for congenital spine/spinal cord malformations.

METHODS

This single-center retrospective study included 120 cases of fetal spine/spinal cord abnormalities detected using fetal ultrasonography (US) and further examined by fetal MRI between 2016 and 2020. Cases were divided into three groups (congenital spine, spinal cord, and spine + spinal cord malformations) based on US assessment. We analyzed the accuracy of fetal US and MRI relative to postnatal imaging.

RESULTS

The diagnostic accuracy of fetal MRI for fetal spinal cord, spine, and spine + spinal cord malformations was 86.2% (25/29), 89.4% (42/47), and 86.3% (38/44), respectively, and the corresponding rates for fetal US were 51.7% (15/29), 87.2% (41/47), and 68.2% (30/44). The diagnostic accuracy did not differ between fetal MRI and US for congenital spine malformations (p > 0.05); for congenital spinal cord malformations and congenital spine + spinal cord malformations, the diagnostic accuracy was significantly higher for fetal MRI than for fetal US (p < 0.05).

CONCLUSIONS

Fetal MRI is effective in the assessment of congenital spine/spinal cord malformations. It can yield information that supplements US findings, especially for congenital spinal cord malformations, and can improve the accuracy of fetal diagnosis.

摘要

目的

评估胎儿磁共振成像(MRI)对先天性脊柱/脊髓畸形的诊断价值。

方法

本单中心回顾性研究纳入了 2016 年至 2020 年间,因胎儿超声(US)检查发现胎儿脊柱/脊髓异常而进一步行胎儿 MRI 检查的 120 例病例。根据 US 评估,将病例分为先天性脊柱畸形、脊髓畸形和脊柱+脊髓畸形三组。分析胎儿 US 和 MRI 相对于产后影像学的准确性。

结果

胎儿 MRI 对胎儿脊髓、脊柱和脊柱+脊髓畸形的诊断准确率分别为 86.2%(25/29)、89.4%(42/47)和 86.3%(38/44),胎儿 US 的相应准确率分别为 51.7%(15/29)、87.2%(41/47)和 68.2%(30/44)。胎儿 MRI 与 US 对先天性脊柱畸形的诊断准确率无差异(p>0.05);但对先天性脊髓畸形和先天性脊柱+脊髓畸形,胎儿 MRI 的诊断准确率明显高于胎儿 US(p<0.05)。

结论

胎儿 MRI 对先天性脊柱/脊髓畸形的评估有效,能提供 US 检查结果的补充信息,尤其是对先天性脊髓畸形,可提高胎儿诊断的准确性。

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