【摘要】 目的:探讨快速MRI对胎儿羊膜带综合征所致四肢先天畸形的诊断价值。方法:搜集本院行产前超声检查(US)和MRI检查的68例孕妇中发现并经引产后胎儿尸检证实的胎儿四肢畸形病例资料12例。这12例孕妇年龄22~34岁,平均27.3岁;其12例胎儿,胎龄20~38周,平均26.8周。US检查后3天内行胎儿肢体轴面、冠状面、矢状面MRI扫描。MRI扫描采用单次激发快速自旋回波(SSFSE)序列。观察胎儿四肢骨骼及软组织的形态、结构,并与US及尸检结果进行比较。结果:快速MRI视野大,运动伪影少,组织分辨力高,能清楚显示四肢骨骼、软组织等解剖结构。引产后尸检发现12例四肢畸形(左前臂缺失3例,右前臂残端畸形4例,左侧手指缺失1例,下肢狭窄环2例,马蹄内翻足畸形2例);US诊断10例,误诊、漏诊各1例;MRI诊断11例,漏诊1例。比较两者正确诊断数及误漏诊数,采用四格表的确切概率法检验,P>0.05,差异无统计学意义。结论:MRI对胎儿四肢先天畸形具有较高的诊断价值,是胎儿肢体先天畸形影像学诊断的重要手段之一。更多还原

【Abstract】 Objective:To evaluate the ability of fast magnetic resonance imaging （MRI） to detect fetal peromelies of amniotic band syndrome and to compare its performance with that of prenatal ultrasonography （US）.Methods:Sixty-eight pregnant women were examined by conventional prenatal US and MRI,from which twelve fetuses with peromely were detected and confirmed by autopsy.Axial,sagittal or coronal SSFSE T₂WI MRI examination with a 1.5T MR scanner （Signa CV/i,GE Medical Systems,Milwaukee,Wis） within 3 days after US examinations were performed.Gestational age ranged 20³8 weeks,with a mean of 26.8 weeks.US were performed with a US scanner （Sequoia 512,Acuson/Siemens,Mountain View,Calif） with a 3.5⁵MHz probe.The MR and US appearances of fetal structure were compared to each other and to that of autopsy.Results:A total of 12 peromelies were identified by autopsy including left forearm depletion （n=3）,right forearm stump （n=4）,left fingers depletion （n=1）,stenotic rings of lower extremity （n=2） and club foot （n=2）.US diagnosed 10 peromelies,the correct diagnostic rate was 83.3%,the false-positive rate was 8.3%,the missed-diagnostic rate was 8.3%.MRI diagnosed 11 peromelies,the correct-diagnostic rate was 91.7%,the false-positive rate was 0,the missed-diagnostic rate was 8.3%.There was no difference between US and MRI （P>0. 05）,but MRI had larger FOV,higher tissue resolution,and could better demonstrate bone muscle and soft tissue.Conclusions:MR imaging has a similar sensitivity to that of US in the detection of fetal peromelies of amniotic band syndrome.更多还原