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目的探讨磁共振成像(MRI)在诊断胎儿泌尿系统发育异常中的应用价值。方法应用Philips Achieva1.5T超导型磁共振设备,对产前超声拟诊为泌尿系统发育异常的27～38孕周的胎儿腹部进行检查,行SSh-FSET2WI和FFE T1WI序列轴位、冠状位扫描,33例行产后超声或引产后尸检随访。分析33例胎儿泌尿系统发育异常的MRI表现,并与随访结果比较得出MRI诊断准确率。结果 33例经产前MRI诊断胎儿泌尿系统异常中,多囊性发育不良肾4例、多囊肾5例、肾发育不良3例、异位肾4例、肾缺如4例、马蹄融合肾2例、肾盂输尿管结合处异常4例、重复肾2例以及膀胱输尿管结合处异常5例。与产后超声及引产后尸检结果比较,MRI诊断正确30例,误诊3例,诊断准确率90.9%。结论 MRI在胎儿泌尿系统发育异常诊断中具有较高应用价值,可作为产前超声的重要补充检查手段。
Objective To investigate the value of magnetic resonance imaging (MRI) in the diagnosis of fetal urinary system dysplasia. Methods Philips Achieva1.5T superconducting magnetic resonance (MR) apparatus was used to examine the fetal abdomen of 27- to 38-week-old fetuses with prenatal ultrasound diagnosis of urinary tract dysplasia. The axial and coronal scan of SSh-FSET2WI and FFE T1WI , 33 cases were postpartum ultrasound or autopsy after autopsy. 33 cases of fetal urinary system dysplasia MRI performance analysis and follow-up results obtained MRI diagnostic accuracy. Results Among the 33 cases diagnosed as fetal urinary system abnormalities by prenatal MRI, 4 cases were polycystic hypoplasia, 5 cases were polycystic kidney disease, 3 cases were renal dysplasia, 4 cases were ectopic kidney, 4 cases were renal insufficiency, 2 cases, abnormal ureteropelvic junction in 4 cases, 2 cases of repeated renal and ureter junction abnormalities in 5 cases. Compared with the results of postpartum ultrasound and autopsy after autopsy, MRI diagnosis was correct in 30 cases, misdiagnosis in 3 cases and diagnostic accuracy of 90.9%. Conclusion MRI is of high value in the diagnosis of fetal urinary system dysplasia and can be used as an important supplementary test for prenatal ultrasound.