Hubbard A M, Crombleholme T M, Adzick N S
Department of Radiology, The Children's Hospital of Philadelphia and The University of Pennsylvania School of Medicine, 19104, USA.
Am J Perinatol. 1998 Apr;15(4):253-7. doi: 10.1055/s-2007-993937.
Airway compromise at birth can be anticipated with giant neck masses, so that as much anatomic information as possible is necessary prior to delivery to establish a diagnosis and assess the airway. With this study, we evaluated the usefulness of prenatal magnetic resonance imaging (MRI) for evaluation of giant fetal neck masses prior to operating on placental support, the Ex Utero Intrapartum Treatment (EXIT) procedure, performed to secure the neonatal airway. Three pregnant women with an ultrasound (US) diagnosis of fetal giant neck mass were referred for prenatal MRI. As this was our initial experience performing prenatal MRI, a variety of imaging sequences were used including spin-echo, fast gradient-echo, half-fourier single shot turbo spin-echo (Haste), and echo-planar imaging (EPI). All sequences performed were able to demonstrate the fetal airway relative to the mass. In addition, the images were able to give a more global definition of the mass because of the larger field of view than could be obtained with MRI compared to US. The Haste sequence provided the best definition of a mass because of decreased motion artifacts. The prenatal diagnosis on MRI was teratoma in two and lymphangioma in one and was confirmed at birth. MRI provided essential information about the diagnosis and the anatomy of the giant neck masses and adjacent airway in three fetuses prior to selection for the EXIT surgical procedure.
出生时气道受压可由巨大颈部肿块引起，因此在分娩前需要尽可能多的解剖学信息以明确诊断并评估气道。通过本研究，我们评估了产前磁共振成像（MRI）在胎盘支持下进行手术（即子宫外产时处理，EXIT手术，用于确保新生儿气道安全）前评估巨大胎儿颈部肿块的有效性。三名经超声（US）诊断为胎儿巨大颈部肿块的孕妇被转诊进行产前MRI检查。由于这是我们首次进行产前MRI检查，因此使用了多种成像序列，包括自旋回波、快速梯度回波、半傅里叶单次激发快速自旋回波（Haste）和回波平面成像（EPI）。所有执行的序列都能够显示相对于肿块的胎儿气道。此外，由于与超声相比，MRI的视野更大，图像能够更全面地界定肿块。由于运动伪影减少，Haste序列对肿块的显示最佳。MRI产前诊断为畸胎瘤2例，淋巴管瘤1例，出生时得到证实。在选择EXIT手术前，MRI为三个胎儿的巨大颈部肿块及其相邻气道的诊断和解剖提供了重要信息。
