产前MRI对胎儿大脑皮层发育畸形的评估价值

The Value of Prenatal MRI in The Evaluation of Fetal Cerebral Cortical Malformations

目的 探讨产前磁共振成像(magnetic resonnce imaging, MRI)对胎儿大脑皮层发育畸形(malformation of co rtical development, MCD)的评估价值。方法 选取2017年6月至2020年12月期间在本院行超声检查及MRI检查的1675例孕妇临床资料及影像学资料进行回顾性分析比较超声检查及MRI检查MCD的检出率,并记录孕妇妊娠情况。结果 1675例孕妇中,超声检查提示有51倒MCD,其中小头畸形23倒,灰质异位20例,半侧巨脑畸形8例,检出率为3.04%。MRI检查提示有80例MCD,检出率为4.78%,除了超声诊断的MCD,还有17例经MRI检查证实为脑裂畸形8例,颞叶缺失5倒,结节性硬化4例。超声与MRI检查MCD的检出率比较,差异有统计学意义(P<0.05);80例检查出有MCD的孕妇,65例终止妊娠,其中14例行尸检、尸体MRI检查证实产前诊断;15例继续妊娠,患儿出生后均表现为生长发育、智力发育落后a结论 MCD产前超声、MRI检查具有一定特征性,MRI检查作为超声产前筛查的补充手段,能提高MCD检出率。

Objective to evaluate the value of prenatal magnetic resonance imaging(MRI) in the evaluation of malformation of cortical development(MCD).Methods the clinical and imaging data of 1675 pregnant women who underwent ultrasound and MRI examination in our hospital from June 2017 to December2020 were retrospectively analyzed.The detection rate of MCD by ultrasound and MRI was compared,and the pregnancy was recorded.Results Among 1675 pregnant women,ultrasound examination showed that there were 51 cases of MCD,including 23 cases of microcephaly,20 cases of ectopic gray matter and 8 cases of hemigiant brain malformation,with a detection rate of 3.04%.MRI exa mination showed that the detection rate of MCD was 4.78%(80 cases).In addition to MCD,diagnosed by ultrasound,there were 17 cases confirmed by MRI as cerebral fissure deformity(n=8),temporal lobe loss(n=5) and tuberous sclerosis(n=4).There was a significa nt difference in the detection rate of MCD between ultrasound and MRI examination,65 of 80 pregnant women with MCD were terminated,of which 14 cases were diagnosed by autopsy and MRI examination,and 15 cases of continued pregnancy showed growth and mental retardation after birth.Conclusion MCD prenatal ultrasound and MRI examination have certain characteristics.MRI examination,as a supplementary means of ult rasound prenatal screening,ca n improve the detection rate of MCD.