| 王彤,张军.磁共振成像评价胎儿颅内出血:与超声对照分析[J].中国医学影像技术,2016,32(7):1088~1091 |
| 磁共振成像评价胎儿颅内出血:与超声对照分析 |
| Magnetic resonance imaging in evaluation of intracranial hemorrhage in fetuses: Control analysis with ultrasound |
| 投稿时间：2015-11-05 修订日期：2016-04-22 |
| DOI：10.13929/j.1003-3289.2016.07.027 |
| 中文关键词: 胎儿 出血 妊娠结局 磁共振成像 超声检查 产前 |
| 英文关键词:Fetus Hemorrhage Pregnancy outcome Magnetic resonance imaging Ultrasonography prenatal |
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| 中文摘要: |
| 目的 探讨胎儿颅内出血（FICH）的MRI特征及临床价值。方法 回顾性分析39胎FICH的影像及临床资料，观察病灶部位、范围、信号特征、脑室及周围结构、是否合并其他异常，并分级评价FICH的严重程度。将MRI与超声结果进行对照分析。结果 MRI检出率为100%（39/39），包括生发层出血11胎，单纯脑室内出血14胎，生发层出血破入脑室5胎，脑实质出血6胎，蛛网膜下腔出血2胎，硬膜下出血1胎。合并单侧脑室扩张7胎，双侧脑室扩张9胎；合并Dandy-Walker畸形、颞叶发育不全、胼胝体发育不良伴脑穿通畸形、恶性肿瘤伴出血、双侧大脑半球脑软化、严重新生儿缺血缺氧性脑病（HIE）各1胎。39胎中，1级FICH 19胎，其中1a级13胎，1b级6胎；2级FICH 2胎，3级FICH 7胎，其中3a级5胎，3b级2胎；4级FICH 2胎；5级FICH 9胎。超声检出率为28.20%（11/39）。MRI对24~27周、28~31周、32~35周及1a、3a、5级FICH的检出率高于超声，差异均有统计学意义（P均<0.05）。结论 产前MRI可清晰显示FICH出血部位、范围及合并异常，检出率高于超声。 |
| 英文摘要: |
| Objective To investigate MRI characteristics of fetal intracranial hemorrhage (FICH) and its clinical value. Methods Imaging and clinical data of 39 fetuses with FICH were retrospectively analyzd. The severity of FICH was evaluated by observing the location, range, signal characteristics, ventricles and the surrounding structures and the associated abnormalities. MRI and ultrasound results were comparatively analysed. Results The detection rate of MRI was 100% (39/39). MRI findings includied germinal layer hemorrhage in 11 fetuses, simple intraventricular hemorrhage in 14 fetuses, germinal layer intraventricular hemorrhage in 5 fetuses, cerebral hemorrhage in 6 fetuses, subarachnoid hemorrhage in 2 fetuses, subdural hemorrhage in 1 fetus. A total of 7 fetuses combined with unilateral ventriculomegaly, and 9 fetuses combined with dilatation of both ventricles. FICH combined with Dandy Walker malformation, temporal lobe development adverse, corpus callosum development adverse with cerebral perforating defects, malignant tumor with bleeding, softening in bilateral cerebral hemispheres, serious hypoxic ischemic encephalopathy (HIE) was found in each of 1 fetus. Among 39 fetuses, there were 19 fetuses of FICH grade 1 (13 fetuses of grade 1a, 6 fetuses of grade 1b), 2 fetuses of FICH grade 2, 7 fetuses of FICH grade 3 (5 fetuses of grade 3a, 2 fetuses of grade 3b), 2 fetuses of FICH grade 4, 9 fetuses of FICH grade 5. The detection rate of ultrasound was 28.20% (11/39). The detection rate of MRI in gestational age 24-27 weeks, 28-31 weeks, 32-35 weeks, FICH grades 1a, 3a, 5 of FICH were higher than those of ultrasound (all P<0.05). Conclusion Prenatal MRI can clearly display the FICH bleeding site, scope and the combined abnormalities, and the detection rates of MRI is higher than that of ultrasound. |
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