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目的探讨产前MRI在胎儿骶尾部畸胎瘤诊断中的影像表现及应用价值。方法收集2012年8月至2015年12月,我院3627例孕中晚期孕妇中筛出16例胎儿骶尾部畸胎瘤,产前系统超声检查后72h内行MRI扫描,年龄19-37岁,孕21w~33w,平均26±2.1w,男性胎儿3例,女性胎儿13例。分析病变的大小、形态、位置、分型、信号特点及病灶与周围组织的关系。结果 16例骶尾部畸胎瘤中,囊性畸胎瘤7例,囊实性畸胎瘤9例。I型7例,II型4例,III型2例,IV型3例;其中2例I型病灶与骶管相连,2例II型、2例III型、1例IV型畸胎瘤与邻近组织界限不清。4例I型病例术后证实为囊性畸胎瘤,2例III型畸胎瘤术后诊断为良性畸胎瘤,余10例引产后经病理证实3例为恶性畸胎瘤,7例为成熟性畸胎瘤(其中3例为囊性畸胎瘤)。结论胎儿骶尾部畸胎瘤有特征性的位置及MRI表现,MRI对胎儿骶尾部畸胎瘤能准确分型,可为产前临床处理方案提供有力的影像依据。
Objective To investigate the imaging manifestations and the value of prenatal MRI in the diagnosis of sacrococcygeal teratoma. Methods From August 2012 to December 2015, 16 fetuses with sacrococcygeal teratoma were screened from 3627 pregnant women of the second trimester in our hospital. MRI scanning was performed within 72 hours after the ultrasound examination of the prenatal system, aged 19-37 years 21w ~ 33w, an average of 26 ± 2.1w, 3 cases of male fetus, 13 cases of female fetus. Analysis of lesion size, shape, location, type, signal characteristics and the relationship between lesions and the surrounding tissue. Results 16 cases of sacrococcygeal teratoma, cystic teratoma in 7 cases, cystic teratoma in 9 cases. 7 cases of type I, 4 cases of type II, 2 cases of type III and 3 cases of type IV; 2 cases of type I lesions were connected with sacral canal, 2 cases of type II, 2 cases of type III and 1 case of type IV teratoma adjacent to Organizational boundaries are unclear. 4 cases of type I cases confirmed as cystic teratoma, 2 cases of type III teratoma diagnosed as benign teratoma, the remaining 10 cases of postpartum pathology confirmed 3 cases of malignant teratoma, 7 cases were Mature teratoma (3 cases of cystic teratoma). Conclusion Fetal sacrococcygeal teratoma has its characteristic location and MRI manifestations. MRI can accurately classify the fetus sacrococcygeal teratoma, which can provide a powerful imaging basis for prenatal clinical treatment.