超声和MRI在诊断胎儿呼吸系统畸形中的应用

Application of prenatal sonography and MR imaging in the diagnosis of congenital respiratory system lesions

目的探讨超声和MRI联合应用诊断胎儿呼吸系统畸形的临床价值。方法选取超声诊断为呼吸系统畸形的胎儿16例,其中CCAM 12例,BPS 2例,CHAOS 1例,双肺回声增强1例。征得患者同意后,在接受超声检查后24小时内行MRI检查。最终诊断由产后尸检或生后随访证实。结果16例病变的MRI诊断结果与最终结果完全一致。产前超声诊断结果中,12例与最终结果一致;3例误诊;另有1例超声诊断为双肺回声增强、病变性质待查,最终结果为CCAM。结论超声检查能准确诊断大多数胎儿呼吸系统畸形,超声和MRI联合应用可提高呼吸系统畸形的诊断准确率。

Objective To determine if prenatal magnetic resonance imaging （MRI） could provide information in addition to ultrasonography （US） in the diagnosis of congenital respiratory system lesions. Methods Sixteen pregnant women were referred for magnetic resonance imaging in which a fetal respiratory system lesion （12 congenital cystic adenomatoid malformation [CCAM], 2 bronchopulmonary sequestration （BPS）, 1 congenital high airway obstruction syndrome （CHAOS）, 1 bilateral echogenic lung） ware suspected at ultrasonography. The final diagnosis was confirmed by autopsy, postmortem imaging or clinical follow up. Results In all cases, MRI was in agreement with the final diagnosis. In 12 cases, US was in agreement with the final diagnosis. A CCAM was diagnosed according to US, but the final diagnosis was BPS. A BPS was diagnosed according to US, but the final diagnosis was CCAM. A CCAM was suspected according to US, but the final diagnosis was normal. In a case that showed bilateral echogenic lung at US, the final diagnosis was CCAM. Conclusion MR imaging can serve as a supplement to obstetrics sonography in diagnosis of congenital respiratory system lesions.