产前超声联合MRI检查在评估胎儿颅后窝异常中的临床研究

Clinical Value of Prenatal Ultrasound Combined with MRI in Evaluating Abnormalities of Fetal Posterior Cranial Fossa

目的研究产前超声联合MRI检查在评估胎儿颅后窝异常中的临床价值。方法回顾性分析本院2018年4月至2020年5月行产前超声检查诊断为颅后窝异常的39例胎儿的临床资料。观察胎儿小脑结构、第四脑室有无扩张、小脑幕形态有无异常等情况。并分析产前超声联合MRI检查的诊断情况。结果39例胎儿经产前超声检查显示颅后窝异常,经MRI检查显示39例中,颅后窝异常胎儿26例(66.67%),与产前超声诊断一致;颅后窝正常胎儿13例,且产后随访显示目前无明显异常。26例经MRI确诊颅后窝异常病例中,选择继续引产妊娠并活产15例,14例于产后进行了MRI检查,其中7例产前与产后MRI检查结果完全一致;产前、产后MRI诊断不符者3例,其余4例经产后MRI诊断发现了新的颅内异常诊断信息。结论产前超声可有效评估胎儿颅后窝异常,是其首选检查;超声无法明确诊断病变可结合MRI检查,进一步提高诊断准确率。

Objective To study the clinical value of prenatal ultrasound combined with MRI in evaluating abnormalities of fetal posterior cranial fossa.Methods The clinical data of 39 fetuses diagnosed as abnormalities of the posterior cranial fossa by prenatal ultrasound examination in our hospital from April 2018 to May 2020 were retrospectively analyzed.The fetal cerebellar structure and whether the fourth ventricle were expanded,and whether the shape of tentorium was abnormal were observed.The diagnosis of MRI combined with prenatal ultrasound was analyzed.Results Prenatal ultrasound examination of 39 fetuses showed abnormalities in the posterior cranial fossa,and MRI examination showed 26 cases(66.67%)with abnormal fetuses in the posterior cranial fossa,which was consistent with the diagnosis of prenatal ultrasound.There were 13 normal fetuses in the posterior cranial fossa,and postpartum follow-up showed no abnormalities at present.In the 26 cases with abnormalities of the posterior cranial fossa diagnosed by MRI,15 cases selected to continue to induce pregnancy and live birth,and 14 cases were performed postpartum MRI examination.And in them,prenatal and postpartum MRI examinations of 7 cases were completely consistent,prenatal and postpartum MRI examinations of 3 cases were inconsistent,and the remaining 4 cases were found with new diagnostic information about intracranial abnormalities through postpartum MRI.Conclusion Prenatal ultrasound can effectively evaluate the abnormality of the fetal posterior cranial fossa and is the first choice of examination.For the lesions that cannot be clearly diagnosed by ultrasound,MRI examination can be combined to diagnose to further improve the accuracy of diagnosis.