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目的利用磁共振水成像的原理,采用单次激发厚层快速自旋回波(single-shot turbo spin echo,SSTSE)重T2加权序列行磁共振胎儿成像(magnetic resonance fetography,MRF),分析其成像质量及影响因素。评价其作为胎儿三维重建的一种替代方法的可行性。方法2006年4月至2008年2月间,因产前超声筛查诊断或怀疑胎儿存在先天性缺陷以及染色体检查异常的孕妇164例,169个胎儿,羊水正常137例,其中中孕38例,晚孕99例,羊水过多18例,羊水过少9例,羊水正常者头位胎104例,臀位胎29例,横位胎4例,在常规胎儿MRI检查基础上行MRF。对MRF图像进行质量评价,分析图像质量与孕周、胎位和羊水的关系及图像质量降低的原因。结果所有胎儿常规扫描和MRF成像均一次成功。51例胎儿体内的含液器官病理性扩张或萎陷,28例胎儿病理性积液,10例胎儿囊性病变,15例胎儿体表畸形和17例肢体畸形,以及16例母体肾盂积水和13例囊性病变在穿透胎儿表面后,也同时显示。MRF成像质量与胎儿孕龄、胎位、羊水量无统计学差异(P>0.05)。运动伪影、卷积伪影、母亲膀胱过度充盈可使图像质量降低。结论MRF提供了一种具有三维立体感的胎儿整体图像,能在1幅图像上同时捕捉胎儿的解剖和病理,具有快速、多方位、多视角、多次重复优质成像的特点,可以作为胎儿三维成像的一种替代方法。
Objective To evaluate the imaging quality of magnetic resonance tomography (MRF) by using the single-shot turbo spin echo (SSTSE) and T2-weighted serial MRI (Magnetic Resonance Imaging) And influencing factors. Evaluate its feasibility as an alternative to 3D reconstruction of the fetus. Methods From April 2006 to February 2008, 164 pregnant women, 169 fetuses and 137 amniotic fluid were diagnosed or suspected of having congenital defects and chromosomal abnormalities due to prenatal ultrasound screening. Among them, 38 were pregnant, 99 cases of late pregnancy, 18 cases of oligohydramnios, oligohydramnios in 9 cases, normal amniotic fluid in the first 104 cases of fetal head, 29 cases of breech fetal, transverse fetal 4 cases, routine fetal MRI examination on the basis of MRF. The quality of MRF images was evaluated, and the relationship between image quality and gestational age, fetal position and amniotic fluid and the reason of image quality reduction were analyzed. Results All fetal routine and MRF imaging were successful. 51 cases of pathological dilatation or collapse of fluid-containing organs in the fetus, 28 cases of fetal pathological effusion, 10 cases of fetal cystic lesions, 15 cases of fetal surface deformity and 17 cases of limb deformity, and 16 cases of maternal hydronephrosis and 13 cases of cystic lesions in penetrating the fetal surface, also showed. MRF imaging quality and fetal gestational age, fetal position, amniotic fluid volume was no significant difference (P> 0.05). Motion artifacts, convolution artifacts, excessive filling of the mother’s bladder can reduce image quality. Conclusion MRF provides a three-dimensional image of the entire fetus, which can simultaneously capture the anatomy and pathology of the fetus in one image. It has the characteristics of fast, multi-orientation, multi-angle and multiple repetitions of high quality imaging, An alternative to imaging.