Yu Fei, Fu Le, Xu Chengjie, Wang Jue, Huang Xiaowei, Zhang Guofu, Zhang He
Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, P.R. China.
Department of Radiology, Shanghai First Maternity and Infant Health Hospital, School of Medicine, Tongji University, P.R.China.
Curr Med Imaging. 2023 Oct 31. doi: 10.2174/0115734056256514231020103822.
This study aimed to characterize and assess the diagnostic value of prenatal magnetic resonance (MR) imaging in detecting fetal cerebellar hypoplasia/dysplasia and developmental malformations.
Reports of suspected intracranial abnormalities were retrospectively collected on ultrasound screening (US), and MR images of fetuses were reviewed at our institution over a 5-year period on picture archiving and communication system (PACS) servers. Two experienced radiologists recorded major abnormalities and coexisting abnormalities at the reading of the census. The results of the MRI were compared against the US in each case.
For prenatal MR imaging, we enlisted a total of 121 patients (mean gestational week, 24.5 ± 4.7 weeks). This included 28 cases with normal findings of MR imaging, 62 cases with findings of cerebellar hypoplasia or dysplasia, and the remaining 31 cases with other abnormities findings. Cerebral malformations cases included agenesis of the corpus callosum, cerebral hemorrhage, hydrocephalus, holoprosencephaly, ventriculomegaly, and brainstem/gyri malformation. Cerebellar abnormalities included vermis absence, cerebellar tonsil hernia, Dandy-Walker malformation, Blake's pouch cysts, arachnoid cysts, and intracranial hemorrhage. Other systemic malformation cases included tethered cord syndromes (9 cases), cleft lip and palate (1 case), club foot (1 case), and cardiac malformation (1 case). In 12 cases (24.5%), compared to the US, MR imaging proved the value of confirming the diagnosis and/or even yielded more findings on abnormalities.
Prenatal MR imaging can better visualize systemic malformations coexisting with cerebellar abnormalities. MR imaging, a complementary means to the US, can aid in prenatal counseling and treatment selection for term delivery.
本研究旨在描述产前磁共振成像(MRI)在检测胎儿小脑发育不全/发育异常及发育性畸形方面的特征并评估其诊断价值。
回顾性收集超声筛查(US)怀疑有颅内异常的报告,并在5年期间在我们机构的图像存档和通信系统(PACS)服务器上查看胎儿的MRI图像。两名经验丰富的放射科医生在阅片时记录主要异常和并存异常。将每个病例的MRI结果与US结果进行比较。
对于产前MRI成像,我们共纳入121例患者(平均孕周24.5±4.7周)。其中MRI成像结果正常的有28例,小脑发育不全或发育异常的有62例,其余31例有其他异常发现。脑部畸形病例包括胼胝体发育不全、脑出血、脑积水、前脑无裂畸形、脑室扩大以及脑干/脑回畸形。小脑异常包括小脑蚓部缺如、小脑扁桃体疝、Dandy-Walker畸形、Blake囊肿、蛛网膜囊肿和颅内出血。其他全身畸形病例包括脊髓栓系综合征(9例)、唇腭裂(1例)、马蹄内翻足(1例)和心脏畸形(1例)。在12例(24.5%)病例中,与US相比,MRI成像证明了其在确诊方面的价值,甚至还发现了更多异常。
产前MRI成像能更好地显示与小脑异常并存的全身畸形。MRI成像作为US的补充手段,有助于产前咨询和足月分娩的治疗选择。