胎儿唇腭裂的MRI表现

MRI findings of fetal cleft lip and palate

目的探讨MRI诊断胎儿唇腭裂的征象及其优缺点。方法对12例超声怀疑胎儿唇腭裂的孕妇进行胎儿MR检查，并将超声、MRI及随访结果进行对照。结果12例孕妇，检出胎儿12例，随访结果显示1例为不完全型唇裂、11例为完全唇裂并合并腭裂。B超和MRI诊断唇裂的结果与随访一致。胎儿唇裂的MRI表现为胎儿唇部软组织连续性不完全或完全中断，内充填羊水，T2WI呈高信号。腭裂的MRI表现为胎儿腭部组织信号不连续、局部被长T2高信号中断，口腔与鼻腔直接相通。MRI漏诊腭裂1例，正确诊断腭裂10例，正确排除腭裂1例，诊断正确率为91．7％（11／12），敏感度为90．9％（10／11），特异度为100％（1／1）；B超诊断腭裂5例，正确排除腭裂1例，漏诊6例，诊断正确率为50．0％（6／12），敏感度为45．5％（5／11），特异度为100％（1／1）。结论MRI对于腭裂的诊断较B超有一定优势，在超声或其他检查怀疑胎儿有腭裂时，有必要进一步进行MR检查。

Objective To investigate the MR findings of fetal cleft lip （CL） and evaluate the advantages and limitations of MRI in the diagnosis. Methods Twelve pregnant women suspicious of fetal CL/cleft palate（CP） on uhrasonography were enrolled in the study. The findings of ultrasonography, MRI and following-up were compared. Results MRI and uhrasonography detected 12 fetuses with CL/CP. The following-up results showed 1 case with incomplete cleft lip and the other 11 cases with complete cleft lips and cleft palates. MRI and unhrasonography were consistent with the follow-up in CL detection, showing completed or uncompleted soft tissue interruption of the fetal lips with amniotic fluid filling which is high signal on T2WI. On MRI, CP showed discontinuous of the soft tissue which were interrupted by long T2 signal and communicating with oral cavity and nasal cavity. MRI missed 1 case and excluded 1 case of CP. Ultrasonography predicted 5 case of CL, excluded 1 CP but missed 6 cases. The accuracy, sensitivity and specificity in detection CL/CP was 91.7% （ 11/12）, 90. 9% （ 10/11 ）, 100% （ 1/1 ） for MRI and 50. 0% （6/12） ,45.5% （5/11）, 100% （ 1/1 ） for uhrasonography, respectively. Conclusion MR imaging had advantage over ultrasonography in detecting CP, MRI is an essential when CP is suspicious on uhrasonography.