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一例罕见病例报告:胎儿磁共振成像在检测双面联体双胎中的价值

A rare case report: The value of fetal MRI to detect diprosopus twins.

作者信息

Purbasari Utami, Asih Dewi, H Helda, Manurung Reza Tigor, Dewi Puspa, Eureka Agnes Nina

机构信息

Department of Radiology, Fatmawati General Hospital, Jl. RS. Fatmawati Raya, Num4, RT.4/RW.9, West Cilandak, South Jakarta 12430, Indonesia.

Department of Clinical Epidemiology, Faculty of Public Health, University of Indonesia, Jl. Lingkar Kampus Raya Universitas, Depok, West Java 16424, Indonesia.

出版信息

Radiol Case Rep. 2024 Aug 17;19(11):4940-4944. doi: 10.1016/j.radcr.2024.07.055. eCollection 2024 Nov.

Abstract

Diprosopus is one of the rarest types of conjoined twins, caused by incomplete zygote separation in early pregnancy. It defines a condition with duplication of facial structures, monocephalic and 1 trunk. Early detection is difficult, but fetal MRI plays an important role in strengthening antenatal diagnosis of conjoined twin pregnancies and other major congenital abnormalities, complementing antenatal ultrasonography. A 28-year-old patient (G2P1A0) was referred from the regional general hospital for suspected malformations, including Dandy-Walker syndrome and a small mandible Antenatal 3-D ultrasound at 35 weeks revealed a single baby with macrosomia, hypoplasia of the vermis, and cleft lip with malformation of facial structures. A 3 Tesla MRI (Signa, GE Healthcare) revealed various developmental brain anomalies, including duplication of the frontotemporal lobes, corpus callosum agenesis, and small posterior fossa. The identification of 4 orbital structures raised suspicions of face duplication. This patient underwent a caesarean section and delivered a diprosopus twin baby. MRI emerged as an indispensable adjunct, complementing ultrasound in detecting congenital malformations. The success of this approach emphasizes collaborative efforts between clinicians and radiologists for accurate identification and management of complex fetal anomalies.

摘要

双面畸形是连体双胞胎中最罕见的类型之一,由怀孕早期受精卵分离不完全所致。它表现为面部结构重复、单头和一个躯干的情况。早期检测困难,但胎儿磁共振成像(MRI)在加强连体双胎妊娠及其他主要先天性异常的产前诊断方面发挥着重要作用,是对产前超声检查的补充。一名28岁患者(孕2产1,0次流产)从地区综合医院转诊而来,怀疑有包括丹迪-沃克综合征和小下颌在内的畸形。孕35周时的产前三维超声显示为一个巨大儿、小脑蚓部发育不全且伴有唇裂及面部结构畸形的单胎婴儿。一次3特斯拉的MRI(Signa,通用电气医疗集团)检查发现了各种发育性脑异常,包括额颞叶重复、胼胝体发育不全和小后颅窝。发现4个眼眶结构引发了面部重复的怀疑。该患者接受了剖宫产,产下一名双面畸形双胞胎婴儿。MRI成为不可或缺的辅助手段,在检测先天性畸形方面补充了超声检查。这种方法的成功强调了临床医生和放射科医生之间为准确识别和管理复杂胎儿异常而进行的协作努力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ec5/11378094/2797a3f2d466/gr1.jpg

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