MRI在胎儿腹壁缺损的产前诊断价值:脐膨出与腹裂

The Value of MRI in Prenatal Diagnosis of Fetal Abdominal Wall Defect:Omphalocele and Gastroschisis

目的:探讨MRI在胎儿腹壁缺损的产前诊断价值。方法:收集上海儿童医学中心2008—2019年产前MRI确诊并经出生后随访的胎儿腹壁缺损24例,对其MRI表现及特点进行回顾性分析。结果:脐膨出膨出物表面由包膜覆盖,腹裂为全层腹壁缺损,疝出物表面无包膜覆盖。(1)脐膨出13例:膨出物位于脐带下方5例、上方3例、右侧2例,脐带位于膨出物顶部3例;膨出物含肝脏和/或胆囊12例,肠管4例,胃泡5例;合并其他畸形8例。(2)腹裂11例:裂口位于脐带右侧5例,左侧2例,上方3例,下方1例;疝出物含肝脏和/或胆囊4例,肠管10例;合并其他畸形5例。结论:MRI可以诊断胎儿腹壁缺损,提供全面和详细的解剖信息,评估缺陷的程度,帮助临床医师评估预后,并有助于确诊可疑病例。

Purpose:To investigate the diagnostic value of prenatal MRI for fetal abdominal wall defects.Methods:Twenty-four cases of fetal abdominal wall defects diagnosed with prenatal MRI and followed up after birth detected in Shanghai Children's Medical Center from 2008 to 2019 were collected in the study,and their MRI findings and characteristics were retrospectively analyzed.Results:The surface of the omphalocele was covered by the envelope,while the gastroschisis was a full abdominal wall defect,and the surface of the herniated object was not covered by the envelope.(1)There were 13 cases of omphalocele,which was located below the umbilical cord in 5 cases,above the umbilical cord in 3 cases,and on the right side of umbilical cord in 2 cases,while the umbilical cord was on the top of the bulge in 3 cases.The bulge contained liver and/or gallbladder in 12 cases,intestinal tube in 4 cases,and gastric vesicle in 5 cases.Eight cases were associated with other malformations.(2)There were 11 cases of abdominal fissure,which was located on the right side of umbilical cord in 5 cases,on the left side of umbilical cord in 2 cases,above the umbilical cord in 3 cases,and below the umbilical cord in 1 case.The herniation contained liver and/or gallbladder in 4 cases,intestinal tube in 10 cases.Five cases were associated with other malformations.Conclusion:Magnetic resonance imaging can diagnose fetal abdominal wall defects,provide comprehensive and detailed anatomical information,evaluate the degree of defects,help clinicians evaluate the prognosis.