摘要
目的探讨磁共振成像(MRI)在胎儿泌尿生殖系统异常诊断中的价值。方法回顾性分析72例随访证实为泌尿生殖系统异常胎儿的产前MRI,其中泌尿系统61例、生殖系统11例,孕龄21～39周,平均29周,以胎儿出生后或引产后随访结果为参考标准,与产前MRI、US诊断结果对比分析。通过MRI采用感兴趣区工具(ROI)测量胎儿肺肝信号强度比(LLSIR),采用t检验进行统计学分析。结果61例泌尿系异常其中肾不发育9例(同时伴肺发育不良2例),盆腔异位肾2例,多囊性发育不良肾15例(同时伴肺发育不良5例),梗阻性尿路疾病23例(其中重复畸形或输尿管异位开口3例、同时伴肺发育不良1例),肾发育不良9例(同时伴肺发育不良3例),脐尿管囊肿2例(1例合并睾丸鞘膜积液),左肾上腺神经母细胞瘤1例;11例生殖系统异常其中卵巢囊肿8例,睾丸鞘膜积液2例,右卵巢畸胎瘤1例,其中1例睾丸鞘膜积液存在全身水肿,1例卵巢囊肿还存在脑发育不良及右心房增大。MRI诊断准确率为95.8%。11例羊水过少肺发育不良胎儿LLSIR为1.06～1.29,平均值为1.20±0.08,较正常明显减低(P=0.000<0.05)。结论MRI是胎儿泌尿生殖系统异常较有价值的产前影像诊断方法。能提供超声以外的信息,发挥超声的重要补充作用,尤其是超声显示不清时。
Objective To explore the value of MRI on abnormalities of fetal genitourinary system. Methods The prenatal MR images of 72 fetuses followed up with 21-39 weeks of gestation （average 29 weeks） were analyzed retrospectively and compared with prenatal ultrasound or autopsy or postnatal follow-up results. Calculation of the ratio of lung signal intensity to liver signal intensity （LLSIR） was performed on MR by using region-of-interest analysis; t test was performed. Results MRI diagnoses included 61 urinary tract and 11 genital disorders. A total of 61 fetuses with urinary tract disorders included enlarged renal agenesis （n= 9, 2 fetuses with ollgohydramnios）, pelvic kidney （n=2）, multicystic dyplastic kidney （n=15, 5 fetuses with oligohydramnios）, obstructive urinary tract anomalies （n= 23, 3 fetuses with renal duplication and or not ectopic ureter, 1 fetus with oligohydramnios）, renal d ysplasia （n=9, 3 fetuses with oligohydramnios）, urachal cyst （n=2, one with hydrocele） and left-sided adrenal neuroblastoma （n= 1）. A total of 11 fetuses with genital disorders included ovarian cyst （n = 8,1 fetus with brain hypoplasia and right atrium enlargement）, hydrocele （n = 2,1 fetus with hydrosarca）, right-sided ovarian teratoma （n=1）. MRI findings were confirmed in 72 fetuses at autopsy or postnatal follow-up, 95.8% （69/72） was correct, 4.2% （3/72） was incorrect. 11 hypoplastic lungs associated with oligohydramnios had a mean LLSIR of 1.20±0.08 （range, 1.06-1.29） and obviously less than the LLSIR for normal lungs in fetuses of similar gestational age （P=0. 000〈0.05）. Conclusion Prenatal MRI is an effective tool in the assessment of genitourinary anomalies of fetuses. It can provide additional information to the US-determined diagnosis and is a useful complementary tool to US, particularly in cases with inconclusive sonographic findings.
出处
《中国医学影像技术》
CSCD
北大核心
2008年第1期118-122,共5页
Chinese Journal of Medical Imaging Technology
基金
上海市“创新行动计划”项目基础研究重点项目(07JC14043)。
关键词
胎儿
先天畸形
泌尿生殖系统
磁共振成像
Fetus
Congenital abnormalities
Genitourinary system
Magnetic resonance imaging
