Levine D, Barnes P D, Madsen J R, Li W, Edelman R R
Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Radiology. 1997 Sep;204(3):635-42. doi: 10.1148/radiology.204.3.9280237.
To evaluate fetuses with sonographically suspected central nervous system anomalies to determine the frequency with which obstetric magnetic resonance (MR) imaging adds clinically useful information to that provided by ultrasonography (US).
US and MR images and diagnoses in 18 pregnant women were reviewed and compared by two radiologists. Postnatal physical examination and imaging findings and fetal autopsy results were standards. Referring physicians were questioned as to how the additional information provided by MR imaging changed patient counseling.
In 10 (55%) patients, MR imaging demonstrated 11 additional findings. These findings were agenesis of the corpus callosum (n = 4), cerebellar hypoplasia (n = 2), cortical cleft (n = 2), polymicrogyria (n = 1), porencephaly (n = 1), and partial agenesis of the septi pellucidi (n = 1). In seven (39%) patients, additional information provided by MR imaging altered counseling. In one case of suspected agenesis of the corpus callosum, diagnosis at MR imaging was at least partially incorrect.
US and MR imaging are complementary imaging methods in the evaluation of high-risk pregnancy. When a central nervous system anomaly is suspected at US, MR imaging may demonstrate additional findings that can alter patient counseling.
评估超声怀疑有中枢神经系统异常的胎儿，以确定产科磁共振成像（MR）在超声（US）提供的信息基础上增加临床有用信息的频率。
两位放射科医生回顾并比较了18例孕妇的超声和磁共振图像及诊断结果。产后体格检查、影像学检查结果及胎儿尸检结果作为标准。询问转诊医生磁共振成像提供的额外信息如何改变患者咨询。
10例（55%）患者中，磁共振成像显示了11项额外发现。这些发现包括胼胝体发育不全（n = 4）、小脑发育不全（n = 2）、皮质裂（n = 2）、多小脑回（n = 1）、脑穿通畸形（n = 1）和透明隔部分发育不全（n = 1）。7例（39%）患者中，磁共振成像提供的额外信息改变了咨询。在1例疑似胼胝体发育不全的病例中，磁共振成像诊断至少部分有误。
超声和磁共振成像是评估高危妊娠的互补成像方法。当超声怀疑有中枢神经系统异常时，磁共振成像可能显示可改变患者咨询的额外发现。
