| 朱俊丞,贾凤林,廖怡,宁刚,李学胜,张毓瑾,曲海波.胎儿MRI诊断十二指肠梗阻[J].中国医学影像技术,2025,41(10):1633~1636 |
| 胎儿MRI诊断十二指肠梗阻 |
| Fetal MRI in diagnosis of duodenal obstruction |
| 投稿时间：2025-04-28 修订日期：2025-10-16 |
| DOI：10.13929/j.issn.1003-3289.2025.10.004 |
| 中文关键词: 胎儿 十二指肠梗阻 磁共振成像 |
| 英文关键词:fetus duodenal obstruction magnetic resonance imaging |
| 基金项目:国家自然科学基金(82572198)、四川省科技计划项目(2025YFHZ0068)。 |
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| 中文摘要: |
| 目的 观察胎儿MRI诊断十二指肠梗阻(DO)的价值。方法 回顾性纳入35胎MRI疑诊DO胎儿,测量扩张段肠管长度及其最大径,评估梗阻位置(由近到远位于十二指肠降段、水平段或远段/空肠近端)及梗阻程度(完全性或不全性)。以引产标本、产后新生儿手术所见或随访所见为标准,计算MRI诊断胎儿DO的阳性预测值(PPV),分析扩张段肠管测值与真实梗阻位置及梗阻程度的相关性。结果 35胎中,34胎证实为DO,MRI诊断胎儿DO的PPV为97.14%(34/35);其中23胎为十二指肠降段梗阻(DDO)、4胎为十二指肠水平段梗阻(HDO)、7胎为十二指肠远段/空肠近端梗阻(ADO/PJO);12胎为完全性DO、22胎不全性DO。MRI诊断DDO、HDO及ADO/PJO的PPV分别为87.50%(21/24)、50.00%(2/4)及100%(7/7),诊断完全性及不全性DO的PPV分别为90.00%(9/10)及84.00%(21/25)。MRI显示胎儿十二指肠扩张段长度及其最大径均与真实梗阻位置(由近及远)呈正秩相关(rs=0.736,P＜0.001;rs=0.424,P=0.011)而均与梗阻程度无明显秩相关(rs=－0.216,P=0.212;rs=－0.285,P=0.097)。结论 胎儿MRI可评估十二指肠扩张段肠管长度、最大径以提示DO梗阻位置、评估DO梗阻程度。 |
| 英文摘要: |
| Objective To observe the value of fetal MRI in diagnosis of duodenal obstruction (DO). Methods A total of 35 fetuses with suspected DO according to MRI were retrospectively included. The length and the maximum diameter of the dilated duodenum were measured, so as site (categorized in descending order from proximal to distal as descending segment, horizontal segment and ascending duodenum/proximal jejunum) and the degree of obstruction (complete or incomplete) were assessed. Taken findings of labor induction specimen, postnatal neonatal surgery or follow-up data as standards, the positive predictive value (PPV) of MRI for diagnosing fetal DO was calculated, while the correlations of the measured parameters of dilated duodenum and the confirmed obstruction site/degree were analyzed. Results Among 35 fetuses, DO was confirmed in 34 fetuses, yielding an overall PPV of 97.14% (34/35) for MRI. In 34 fetuses with confirmed DO, there were 23 with descending DO (DDO), 4 with horizontal DO (HDO) and 7 with ascending DO/proximal jejunum obstruction (ADO/PJO), including 12 with complete DO and 22 with incomplete DO. PPV of MRI for diagnosing DDO, HDO and ADO/PJO was 87.50% (21/24), 50.00% (2/4) and 100% (7/7), respectively, for diagnosing complete and incomplete DO was 90.00% (9/10) and 84.00% (21/25), respectively. Both the length and the maximum diameter of fetal proximal dilated duodenum showed on MRI were positively correlated with the actual obstruction site (from proximal to distal) (rs=0.736, P＜0.001; rs=0.424, P=0.011, respectively), but had no significant rank correlation with the degree of obstruction (rs=－0.216, P=0.212; rs=－0.285, P=0.097, respectively). Conclusion Fetal MRI could effectively evaluate the length and the maximum diameter of dilated duodenum hence indicating the level and degree of DO. |
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