胎儿胸部异常的MRI诊断

MRI Diagnosis of Fetal Thoracic Abnormalities

目的:分析9例胎儿胸部异常的MRI表现,探讨MRI在胎儿胸部异常诊断中的补充作用。方法:对9例产前超声检查发现的胎儿胸部异常病例,经孕母及家属同意后行胎儿多平面的MRT2WI扫描,部分病例加做T1WI扫描,对胎儿异常胸部MRI表现进行研究,进一步确定胸部异常类型。结果:9例胸部异常中,6例先天性肺囊腺瘤样畸形(CCAM),3例为右肺CCAM,3例为左肺CCAM,MRI表现为患侧肺内多囊样T2WI高信号改变,病侧肺体积增大,纵隔向对侧移位;1例为左侧先天性膈疝(CDH),MRI示左侧胸腔内正常肺组织消失,呈混杂肠腔信号,肺尖少许正常肺组织受压;2例为胸腔积液,1例表现为双侧胸水、腹水、睾丸鞘膜积液,考虑为胎儿免疫性水肿,另1例为右侧胸水、腹水、皮下软组织水肿。结论:MRI作为产科胎儿超声检查的一种重要补充方法,对病变多方位的显示,具有很高的价值,给临床诊断及治疗予以很大帮助。

Objective：To illustrate the important complemental function of MRI in dignosing the fetal abnormalities by analyzing MR features of 9 cases of thoracic abnormalities. Methods： MRI findings of thoracic abnormalities in 9 fetuses were retrospectively analyzed. According to the patients and family members approval,all the patients were performed MR Tz WI scans,and part of them performed MR TI WI scans. Results：Of all the nine cases of thoracic abnormalities, six were congenital cystic adenomatoid malformation （CCAM）（3 right lung CCAM, 3 left lung CCAM） ;multisacculate changes with high signal on Tz WI, enlargement of affected lung volume and mediastinal shifting to the opposite side were the main appear.ances. There was one case of left congenital diaphragmatic hernia （CDH）,it showed disappearence of the normal lung tissue,and mixed signal of the intestine could be seen in the thoracic cavity. Two cases were hydrothorax,one of them was considered due to fetus immunity edema and the other was pleural fluid,ascites and suhcutaneou soft tissue edema. Conclusion： MRI is of great value in displaying and diagnosing the thoracic abnormalities of fetus as a complementary method.