产前MRI在胎儿骶尾部畸胎瘤中的诊断价值

Prenatal MRI in the diagnosis value of fetal sacrococcygeal teratoma

目的探讨产前MRI在胎儿骶尾部畸胎瘤诊断中的影像表现及应用价值。方法收集2012年8月至2015年12月,我院3627例孕中晚期孕妇中筛出16例胎儿骶尾部畸胎瘤,产前系统超声检查后72h内行MRI扫描,年龄19-37岁,孕21w^33w,平均26±2.1w,男性胎儿3例,女性胎儿13例。分析病变的大小、形态、位置、分型、信号特点及病灶与周围组织的关系。结果 16例骶尾部畸胎瘤中,囊性畸胎瘤7例,囊实性畸胎瘤9例。I型7例,II型4例,III型2例,IV型3例;其中2例I型病灶与骶管相连,2例II型、2例III型、1例IV型畸胎瘤与邻近组织界限不清。4例I型病例术后证实为囊性畸胎瘤,2例III型畸胎瘤术后诊断为良性畸胎瘤,余10例引产后经病理证实3例为恶性畸胎瘤,7例为成熟性畸胎瘤(其中3例为囊性畸胎瘤)。结论胎儿骶尾部畸胎瘤有特征性的位置及MRI表现,MRI对胎儿骶尾部畸胎瘤能准确分型,可为产前临床处理方案提供有力的影像依据。

Objective： To investigate the prenatal MRI in the diagnosis of fetal sacrococcygeal teratoma imaging performance and application value. Methods： Collected in August 2012 to December 2015, our hospital 3627 cases of pregnancy middle-late screen out of 16 cases of fetal sacral tail teratoma in pregnant women, prenatal ultrasound system after 72 h adept MRI scanning, age 19-37, at 21 - 33 weeks, average 26±2.1 w, 3 cases of male, female fetuses in 13. Analysis of the lesion size, shape, location, type, signal characteristics and the relationship between the lesion and surrounding tissue. Results： 16 cases of sacrococcygeal teratoma, cystic teratoma in 7 cases, 9 cases of solid cystic teratoma. Type I 7 cases, 4 cases of the type II and type III in 2 cases, type IV （3 cases） ; Including 2 cases of type I lesions and sacral canal are linked together, 2 cases of type II, 2 cases of type III, 1 case of type IV teratoma and adjacent tissue boundaries is not clear. 4 cases of type I confirmed cases of cystic teratoma, 2 cases of type III teratoma were diagnosed as benign teratoma, 10 cases confirmed by pathology after induced labor 3 cases of malignant teratoma, 7 cases for maturity teratoma （3 cases of cystic teratoma） . Conclusion： Fetal sacrococcygeal teratoma has characteristic position and MRI manifestations of MRI at the rear of fetal sacral teratoma can accurate classification, can provide powerful images for prenatal clinical treatment scheme.