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产前超声、磁共振成像及胎儿胸腹部畸形的治疗选择:影像学研究。

Prenatal ultrasound, magnetic resonance imaging and therapeutic options for fetal thoracic anomalies: a pictorial essay.

机构信息

Pediatric Radiology Unit, Radiology Department, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013, Seville, Spain.

Department of Pediatric Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

Pediatr Radiol. 2023 Sep;53(10):2106-2119. doi: 10.1007/s00247-023-05681-y. Epub 2023 May 11.

Abstract

Congenital thoracic anomalies are uncommon malformations that require a precise diagnosis to guide parental counseling and possible prenatal treatment. Prenatal ultrasound (US) is the gold standard imaging modality to first detect and characterize these abnormalities and the best modality for follow-up. Fetal magnetic resonance imaging (MRI) is a complementary tool that provides multiplanar assessment and tissue characterization and can help estimate prognosis. Prenatal treatment is increasingly being used in fetuses with signs of distress and to potentially decrease morbidity and mortality. In this essay, the authors illustrate side-by-side US, MRI and therapeutic options for congenital thoracic anomalies in cases that presented to a tertiary pediatric hospital during the 7-year period 2014-2021. Entities included are congenital diaphragmatic hernia, congenital pulmonary airway malformation, bronchopulmonary sequestration, hybrid lesions, foregut duplications cysts and congenital lobar overinflation. Treatment options include maternal steroids, thoraco-amniotic shunt and fetal endotracheal occlusion. Recognition of typical findings in congenital thoracic anomalies is helpful to establish diagnosis, predict prognosis and plan perinatal treatment.

摘要

先天性胸部异常是罕见的畸形,需要精确的诊断来指导父母咨询和可能的产前治疗。产前超声(US)是首次检测和特征描述这些异常的金标准成像方式,也是最佳的随访方式。胎儿磁共振成像(MRI)是一种补充工具,可提供多平面评估和组织特征,并有助于估计预后。有窘迫迹象的胎儿越来越多地接受产前治疗,以降低发病率和死亡率。在这篇文章中,作者展示了 2014 年至 2021 年期间在一家三级儿科医院就诊的先天性胸部异常病例的超声、MRI 并排图像和治疗选择。所包括的实体有先天性膈疝、先天性肺气道畸形、支气管肺隔离症、混合病变、前肠重复囊肿和先天性肺过度膨胀。治疗选择包括母亲使用类固醇、胸羊水分流和胎儿气管内闭塞。识别先天性胸部异常的典型表现有助于建立诊断、预测预后和计划围产期治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf30/10497640/d52ab13a3fe0/247_2023_5681_Fig1_HTML.jpg

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