Schwarz Michael, Schmidbauer Victor Ulrich, Malik Jakob, Nowak Nikolaus Michael, Kienast Patric, Watzenboeck Martin, Stuempflen Marlene, Schwarz Caroline, Kittinger Jakob, Bettelheim Dieter, Haberl Christina, Binder Julia, Kiss Herbert, Reiberger Thomas, Prayer Daniela, Kasprian Gregor
Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
Eur Radiol. 2025 Mar;35(3):1605-1614. doi: 10.1007/s00330-024-11228-y. Epub 2024 Dec 11.
Intrauterine transfusions (IUTs) are a life-saving treatment for fetal anemia. However, with each transfusion, iron bypasses uptake regulation through the placenta and accumulates in fetal organs. Unlike other imaging modalities, fetal magnetic resonance imaging (MRI) is capable of non-invasively assessing fetal liver disease and/or organ iron overload. This study aimed to investigate the effects of IUTs on MRI findings in the fetal liver and spleen.
For this retrospective study, we included eight fetuses undergoing IUT and prenatal MRI from 2014 to 2023. The fetuses were gestational age-matched with a cohort that received fetal MRI for other indications, but no IUTs. Signal intensity (SI) and volumetric analyses of the liver and the spleen were performed.
Fetuses receiving transfusions had significantly larger volumes of both liver (p = 0.003) and spleen (p = 0.029). T1 SI inversely correlated with the number of IUTs (Pearson's r = -0.43, p = 0.099). This effect regressed over time (r = 0.69, p = 0.057). T2 SI did not correlate significantly with transfusion frequency but showed a strong positive correlation with the number of days between IUT and MRI (r = 0.91, p = 0.002). For splenic SI measures, similar effects were observed regarding T1 SI reduction per received transfusion (r = -0.36, p = 0.167) and recovery of T2 SI after IUT (r = 0.88, p = 0.004).
This is the first study to report the effects of IUTs on MRI data of fetal livers and spleens. We observed considerable dose- and time-dependent SI alterations of the liver and spleen following IUT. Furthermore, fetal hepatosplenomegaly can be expected following IUT.
Question What fetal changes are found by MRI after life-saving intrauterine transfusion (IUT)? Findings Dose- and time-dependent reductions in signal intensity of the fetal liver and spleen, as well as hepatosplenomegaly, were found after intrauterine transfusion. Clinical relevance Intrauterine transfusions cause transient iron overload with consequential changes in MRI signal intensity of fetal livers and spleens. Fetal hepatosplenomegaly can be expected following transfusions. Radiologists' awareness of changes following IUT may improve report quality.
宫内输血（IUT）是治疗胎儿贫血的一种挽救生命的疗法。然而，每次输血时，铁会绕过胎盘的摄取调节，在胎儿器官中蓄积。与其他成像方式不同，胎儿磁共振成像（MRI）能够无创评估胎儿肝脏疾病和/或器官铁过载。本研究旨在探讨IUT对胎儿肝脏和脾脏MRI表现的影响。
在这项回顾性研究中，我们纳入了2014年至2023年间接受IUT和产前MRI检查的8例胎儿。这些胎儿的孕周与因其他指征接受胎儿MRI检查但未接受IUT的队列相匹配。对肝脏和脾脏进行了信号强度（SI）和容积分析。
接受输血的胎儿肝脏（p = 0.003）和脾脏（p = 0.029）的体积均显著增大。T1 SI与IUT次数呈负相关（Pearson相关系数r = -0.43，p = 0.099）。这种效应随时间推移而消退（r = 0.69，p = 0.057）。T2 SI与输血频率无显著相关性，但与IUT和MRI检查之间的天数呈强正相关（r = 0.91，p = 0.002）。对于脾脏SI测量，每次输血后T1 SI降低（r = -0.36，p = 0.167）以及IUT后T2 SI恢复（r = 0.88，p = 0.004）也观察到类似效应。
这是第一项报告IUT对胎儿肝脏和脾脏MRI数据影响的研究。我们观察到IUT后肝脏和脾脏存在显著的剂量和时间依赖性SI改变。此外，IUT后可预期出现胎儿肝脾肿大。
问题 挽救生命的宫内输血（IUT）后，MRI发现胎儿有哪些变化？发现 宫内输血后发现胎儿肝脏和脾脏信号强度呈剂量和时间依赖性降低，以及肝脾肿大。临床意义 宫内输血会导致短暂的铁过载，从而使胎儿肝脏和脾脏的MRI信号强度发生变化。输血后可预期出现胎儿肝脾肿大。放射科医生了解IUT后的变化可能会提高报告质量。
Zotero 插件
