产前超声联合磁共振检查对胎儿肺隔离症的诊断价值

Research on the value of prenatal ultrasound combined with MRI in the diagnosis of fetal pulmonary sequestration

目的:探讨产前超声系统筛查联合磁共振(MR)平扫对胎儿肺隔离症(PS)的诊断及鉴别诊断的临床应用价值。方法:回顾性分析9例经尸检病理及产后随访证实的PS胎儿产前检查资料,所有胎儿均行超声检查,并于检查后24 h内行MR检查。对9例胎儿的超声和MR图像资料进行分析,将产前结果与随访结果相比较。结果:产前超声检查诊断的符合率为77.78%;2例误诊,其中1例误诊为腹腔肿物、1例误诊为肺囊腺瘤;产前MR检查诊断的符合率为100%。结论:产前超声检查是诊断胎儿PS的主要筛查方法,MR可直接显示病变的位置、形态及大小,对胎儿PS的诊断及鉴别诊断具有较高的价值,可作为产前超声筛查的重要补充,超声联合MR检查,能够更加深入的评价胎儿PS,提高对该病的诊断率。

Objective： To investigate the value of prenatal ultrasound combined with MRI in the diagnosis and differential diagnosis of fetal pulmonary sequestration. Methods： The prenatal examination data of 9 cases with pulmonary sequestration confirmed by autopsy and postnatal follow-up was analyzed retrospectively. All fetuses were examined by MR examination performed within 24 hours after ultrasound examination. The results of prenatal ultrasound and MRI were analyzed, and the results were compared with the follow up results. Results： The diagnostic accuracy of ultrasound was 77.78%（7/9）, 2 cases were misdiagnosed（one case was misdiagnosed as abdominal mass and one case as pulmonary cystadenoma）. The diagnostic accuracy of MRI was 100%. Conclusion： Prenatal ultrasound is the primary method for pulmonary sequestration. As the supplement, MR can display directly the location, shape, size of the lesion. There is high value in diagnosis and differential diagnosis of fetal pulmonary sequestration. The combination of ultrasound and MRI can further improve the diagnostic accuracy of the disease.