三维超声与MRI对胎儿小脑蚓部发育异常的诊断价值

【目的】探讨三维超声、MRI对胎儿小脑蚓部发育异常的诊断价值。【方法】回顾性分析2017年1月至2018年3月在本院产前检查诊断为小脑蚓部发育异常胎儿30例(异常组)、蚓部发育正常胎儿50例(正常组)的临床及影像学资料。比较三维超声及MRI检测两组胎儿小脑蚓部前后径(AP)、上下径(CC)、脑干小脑幕角(BT)及脑干小脑蚓部角(BV)变化,比较两种方法对胎儿小脑蚓发育异常的检出率,并分析其利弊。【结果】胎儿蚓部AP、CC、BT、BV的三维超声、MRI检测结果比较差异均无统计学意义(P>0.05);与正常组相比,Dandy-Walker畸形、单纯颅后窝池增宽及Blake's囊肿的AP、CC、BT、BV的三维超声、MRI检测值均降低(P<0.05),Dandy-Walker变异AP、CC的三维超声、MRI测量值也降低(P<0.05),而Dandy-Walker变异BT、BV与正常组比较差异无统计学意义(P>0.05);三维超声、MRI对胎儿蚓部发育异常的检出率比较差异无统计学意义(P>0.05)。【结论】三维超声及MRI均可从胎头正中矢状切面准确测量小脑蚓部的AP、CC、BV及BT,从而克服了二维超声小脑正中矢状切面显示不足的缺点;MRI具有视野大、多方位、多参数成像,不易受孕妇肥胖及羊水量影响等特点,对于诊断胎儿小脑蚓部发育异常比超声诊断优势稍胜,但是MRI不能像超声检测实时成像,且MRI花费较高,因此MRI还不能代替超声检查,若超声检查诊断无法明确时,可采用MRI进一步辅助诊断。

MRI Differentiation Diagnosis of Occupying Lesions in Cerebellopontine Angle Area

Objective： To explore the value of magnetic resonance imaging （MRI） in diagnosis of occupying lesions in cerebellopontine angle area. Methods： MRI records of 78 patients with pathologically confirmed occupied lesions in cerebellopontine angle area were analyzed. Results： Of the 78 cases, 48 （61.5%） were unilateral acoustic neuroma, 5 （6.4%） were bilateral acoustic neuroma, 12 （15.4%） were meningioma, 4 （5.1%） were trigeminal neuroma, 3 （3.8%） were lipoma, 2 （2.6%） were melanoma, and 1 （1.3%） was medulloblastoma. According to the anatomic site, tumor lesion character, and MRI signal, the majority of cerebellopontine angle area tumors were diagnosed accurately. Conclusion： MRI plays an important role in diagnosis of occupying lesions in cerebellopontine angle area.