| 关键,张伶,李美芝,郭燕,林玲,罗柏宁.双胎输血综合征：胎儿MR成像诊断[J].中国医学影像技术,2014,30(7):1071~1075 |
| 双胎输血综合征：胎儿MR成像诊断 |
| Twin-twin transfusion syndrome：The role of fetal MR imaging in diagnosis |
| 投稿时间：2013-09-20 修订日期：2014-06-08 |
| DOI： |
| 中文关键词: 胎儿 双胎输血综合征 血流动力学 磁共振成像 |
| 英文关键词:Fetus Twin-twin transfusion syndrome Hemodynamics Magnetic resonance imaging |
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| 中文摘要: |
| 目的 分析双胎输血综合征（TTTS）胎儿的MRI表现，探讨MRI对TTTS的诊断价值。方法 收集有完整MR资料并经临床确诊的TTTS孕妇18例，孕妇孕周为21~31周。MR检查前均接受胎儿超声检查。采用1.5T MR行轴位turbo FLASH T1W序列和矢状位、冠状位及轴位true FISP T2*W序列扫描。在MRI上测量胎儿相关数据，进行分期诊断，并与超声及临床结果对照。结果 本组胎儿经临床和产后病理均证实为TTTS。所有TTTS胎儿MRI均能直接显示单胎盘双羊膜囊双胎妊娠和双胎之间羊水量的差异（受血胎羊水增多）。双顶径、腹横径、大腿横径测量结果显示双胎发育不平衡，受血胎发育优于供血胎。3胎膀胱明显充盈，12例双胎脐带直径存在差异，4例受血胎皮肤水肿，5例出现1胎胎儿死亡。同时检出1胎供血胎中枢神经系统异常。临床分期结果为Ⅰ期4例，Ⅱ期3例，Ⅲ期2例，Ⅳ期4例，Ⅴ期5例。MR将2例Ⅱ期分为Ⅲ期，超声将1例Ⅰ期分为Ⅲ期，2例Ⅰ期分为Ⅱ期。结论 TTTS有典型的MRI表现，胎儿MR可实现分期诊断，可作为超声诊断TTTS的重要补充。 |
| 英文摘要: |
| Objective To describe the MRI features of twin-twin transfusion syndrome (TTTS) and explore the value of fetal MR imaging in staging. Methods A total of 18 women with twin pregnancy of 21-31 gestational weeks who were proven by clinical results, underwent 1.5T MR scan after ultrasound. Axial, coronal and sagittal scanning true FISP T2*WI and axial turbo FLASH T1WI was performed. Relative fetal parameters were measured on MRI, staging diagnosis was performed and compared with ultrasound findings and post-partum pathology. Results In all patients, MR directly showed monochorionic/diamniotic twin pregnancies and difference of amniotic fluid volume (more in recipient). Significant development difference between twins was detected by relative parameter measurement (i.e. head circumference, abdominal width and femoral width). Filled bladder in 3 recipients, different umbilical width in 12 patients, skin edema in 4 recipients and 5 dead fetuses were revealed. Cerebral nerve system abnormality was found in one donor. The terminal clinical staging results showed 4 cases of stage Ⅰ, 3 cases of stage Ⅱ, 2 cases of stage Ⅲ, 4 cases of stage Ⅳ and 5 cases of stage Ⅴ. Fetal MR imaging misdiagnosed 2 cases of stage Ⅱ as Ⅲ, and ultrasound misdiagnosed 1 case of stage Ⅰ as Ⅲ and 2 cases of stage Ⅰ as Ⅱ. Conclusion Fetuses with TTTS have typical MR manifestations. MR can provide staging for TTTS, and it should be an important method as supplement for ultrasound. |
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