MRI快速扫描序列在胎儿前腹壁缺损诊断中的应用

Application of fast MRI sequences in the diagnosis of fetal anterior abdominal wall defect

目的:通过分析31例胎儿前腹壁缺损在快速磁共振扫描序列中的表现,探讨MRI在胎儿前腹壁缺损诊断中的价值及其对临床治疗的指导作用。方法:回顾性分析31例胎儿前腹壁缺损的MRI图像,并与产前超声或分娩后结果进行比较。结果:MRI正确诊断所有31例胎儿前腹壁缺损,其中脐膨出19例,腹裂12例。19例脐膨出胎儿中伴发畸形7例(7/19),12例腹裂胎儿中伴发畸形3例(3/12)。在脐膨出胎儿组中5例经MRI诊断后实行引产终止妊娠,14例活产,其中5例经手术等治疗后死亡,9例存活;在腹裂胎儿组中3例经MRI诊断后实行引产终止妊娠,9例活产,其中2例经手术等治疗后死亡,7例存活。结论:快速MRI在胎儿前腹壁缺损及相关伴发畸形的诊断具有重要作用,是对产前超声的重要补充。

Objective：To study the MRI manifestations of fetal anterior abdominal wall defect（AWD） with fast MR sequences,in order to evaluate the role of MRI in the diagnosis and treatment guidance in clinical practice of this disease entity.Methods：31 prenatal fetuses with anterior AWD including omphalocele（n=19） and gastroschisis（n=12） diagnosed by prenatal ultrasounography（US） and MRI were retrospectively analyzed.The MRI findings were correlated with US or postpartum findings.Results：All fetal anterior AWD could be detected antenatal with MRI.Accompanied malformations in fetuses with omphalocele were assessed in seven cases（7/19,36.8%）,whereas accompanied malformations in gastroschisis were assessed in 3 cases（3/12,25%）.14 fetuses with omphalocele were born alive,5 of them died after treatment,nine babies survived;five cases had pregnancy terminated after the diagnosis of AWD.As for the 12 fetuses with gastroschisis,two of them died after treatment,7 survived.Three cases with gastroschisis had pregnancy terminated.Conclusion：Fast MRI plays an important role in the diagnosis of fetal anterior AWD and accompanied malformation,it is a significant complemental approach of prenatal ultrasonography.