产前MRI诊断及随访胎儿侧脑室前角旁囊肿

Prenatal MRI diagnosis and follow-up of fetal paraventricular anterior horn cysts

目的评价产前MRI诊断胎儿侧脑室前角旁囊肿的价值,并随访观察胎儿转归。方法回顾性分析44胎侧脑室前角旁囊肿胎儿,并跟踪随访观察其MRI特征及妊娠结局。结果44胎中,23胎Ⅰ型、11胎Ⅱ型及10胎Ⅲ型侧脑室前角旁囊肿;T1WI见侧脑室前角旁类圆形/椭圆形、条形低信号,T2WI呈高信号,边界清晰;其中22胎合并其他颅内、外畸形。3种类型囊肿位置(单/双侧)差异无统计学意义(P>0.05),Ⅰ型与Ⅱ型、Ⅱ型与Ⅲ型囊肿性质(单/双囊)差异具有统计学意义(P均<0.0167);左、右侧囊肿最长径差异均具有统计学意义(P均<0.05)。其中19例出生后复查MRI,4例囊性病灶消失,8例病灶较胎儿期缩小,7例无明显改变。结论产前MRI可为胎儿侧脑室前角旁囊肿产前咨询及出生后早期干预提供依据;侧脑室前角旁囊肿胎儿预后与其类型、大小及伴发畸形密切相关。

Objective To observe the value of prenatal MRI in diagnosis and follow-up of fetal paraventricular anterior horn cysts.Methods Data of 44 fetuses with paraventricular anterior horn cysts were retrospectively analyzed,MRI manifestations of fetal paraventricular anterior horn cysts,the changes during follow-up were observed,and the outcomes of pregnancies were recorded.Results There were 23 fetuses of typeⅠ,11 fetuses of typeⅡand 10 fetuses of typeⅢamong 44 fetuses with fetal paraventricular anterior horn cysts.MR T1WI showed round,oval or strip low signals in paraventricular anterior horn,T2WI showed high signal and clear boundary,including 22 fetuses complicated with other intracranial and/or external malformations.No statistical difference of the position(single or double side)among 3 types of cysts(P>0.05),while there was statistical difference of the properties(single or double cyst)between typeⅠand typeⅡcysts,as well as of the properties between typeⅡand typeⅢ(both P<0.0167),and statistical differences of the longest longitude of left and right cysts were detected(all P<0.05).Reexaminations of MR were performed in 19 cases,among them the cystic lesions disappeared after birth in 4 cases,became smaller in 8 cases stage and remained stable in 7 cases compared with those in fetal stage.Conclusion Prenatal MRI could provide evidences for prenatal consultation and early postnatal intervention of fetal paraventricular anterior horn cysts.The prognoses of fetuses with paraventricular anterior horn cysts closely related to the type,size and accompanying malformations of the cysts.