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产前MRI在超声诊断胎儿侧脑室扩张中的临床价值 [中文引用][英文引用]

作者(英文): 
单位(英文): 
关键词:产前MRI 侧脑室扩张 
关键词(英文): 
分类号:R714.53
出版年·卷·期(页码):2012·4·第3期(11-15)
DOI: 20120303
-----摘要:-------------------------------------------------------------------------------------------

目的 探讨产前MRI 对超声发现胎儿侧脑室扩张的进一步诊断价值,以明确是否合并有其它中枢神经系统疾病。方法 回顾性分析2011年1月至2012年5月通过超声发现胎儿孤立性侧脑室扩张或可疑合并有其它中枢神经系统疾病,但不能明确诊断而行产前MR检查的孕妇289例。MRI均在超声检查后3天内进行。在MRI图像上测量双侧侧脑室三角区宽度并诊断是否合并其它中枢神经系统疾病。根据侧脑室扩张程度分为4组:10~12mm组、13~15mm组、16~20mm组及>20mm组。对于超声与MRI间胎儿侧脑室扩张程度测量分组间进行一致性检验,对于胎儿侧脑室扩张程度及单双侧与胎儿合并其它中枢神经系统疾病率间进行χ2检验。结果 超声与MRI间胎儿侧脑室扩张程度测量分组间一致性良好(Kappa值=0.667)。MR检查确诊胎儿侧脑室扩张274例,占超声诊断的94.8%(274/289),其中合并其他中枢神经系统疾病者58例(21.2%,58/274),以胼胝体缺如或发育不良、脑室周围白质软化及Dandy-Walker's变异最常见,胎儿侧脑室16~20 mm组与>20mm组合并中枢神经系统疾病均较10~12mm组与13~15mm组高(P<0.05),13~15mm组比10~12mm组高(P<0.05),16~20 mm组与>20mm组间无明显差异(P>0.05),胎儿双侧侧脑室扩张合并中枢神经系统疾病者高于单侧者(P<0.05)。结论 产前超声发现的胎儿侧脑室扩张,尤其是双侧中重度扩张者,有必要进一步行MRI检查,以弥补超声诊断的不足,以便发现更多的中枢神经系统疾病。

-----英文摘要:---------------------------------------------------------------------------------------

Objective To evaluate the clinical value of prenatal magnetic resonance imaging (MRI) in ultrasound diagnosed fetal isolated cerebral ventriculomegaly. Method A retrospective review of MR images was performed for 289 fetuses with ultrasound diagnosed isolated cerebral ventriculomegaly. Fetal MRI was examined within 3 days and all case were evaluated whether they had additional central nervous system(CNS) abnormalities. Both ventricles of fetuses were measured and each case was classified into 4 groups according to the severity:1012mm,1315mm,1620mm and >20mm.The χ2 test was used to compare the occurrence rate of fetuses with additional CNS abnormalities in different groups and of fetuses with bilateral and unilateral ventriculomegaly. Results Of the 274 fetuses with ventriculomegaly, additional CNS abnormalities were found in 58 of fetuses overall (21.2,58274) using MRI. The most common of them were agenesis or digenesis of the corpus callosum, periventricular leukomalacia and Dandy-Walker's variation. Of fetuses with CNS abnormalities, there were more cases in groups of 1620 mm and >20mm than groups of 1012mm and 1315mm and more in group of 1315mm than in group of 1012mm(P<0.05). Fetuses with bilateral ventriculomegaly had more CNS abnormalities than fetuses with unilateral ventriculomegaly. Conclusions Prenatal MRI is a useful adjunct to US in fetuses of US diagnosed fetal isolated cerebral ventriculomegaly for the diagnosis of additional CNS abnormalities.

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中文著录格式: 赵连新,王光彬,杨林林,武乐斌,史宏璐,白雪,李慧华.产前MRI在超声诊断胎儿侧脑室扩张中的临床价值.中国产前诊断杂志,2012,4(3):11-15.

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