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目的探讨单次激发快速自旋回波序列(SSFSE)在胎儿MR检查先天性肠道闭锁的应用价值。资料与方法对8例孕20周以上超声提示存在先天性肠道闭锁的胎儿行MR检查。采用SSFSE,选择胎儿头颅、躯干的常规体位,并重点行胎儿躯干横断位、冠状位、矢状位扫描,将产前MRI表现与引产后尸体解剖结果相对照。结果8例先天性肠闭锁,引产后尸检证实闭锁部位分别为空肠近段5例和回肠中段3例,后者同时合并胎儿腹腔积液,SSFSE上见扩张肠管以高信号为主;其中2例肠闭锁并发先天性肛门闭锁,SSFSE上扩张肠管内可见低信号胎粪;1例肠闭锁并发先天性食管闭锁,SSFSE上可见食管中段闭锁处高信号;1例肠闭锁并发膈疝,SSFSE冠状位上疝入物为部分肠管,可见左侧胸腔内少许散在高信号。结论 SSFSE MR检查能清楚显示胎儿先天性肠道闭锁,具有一定的临床诊断价值。
Objective To investigate the value of single shot rapid spin echo (SSFSE) in the detection of congenital intestinal atresia by fetal MR imaging. Materials and Methods 8 cases of fetuses with congenital intestinal atresia over 20 weeks of pregnancy were examined by MR. SSFSE was used to select the normal position of the fetus head and trunk. The transverse torsion, coronal and sagittal scan of fetal torso were also performed. The prenatal MRI was compared with the autopsy findings. Results 8 cases of congenital intestinal atresia, post-induction of autopsy confirmed atresia were 5 cases of proximal jejunum and ileum in 3 cases, the latter combined with fetal ascites, SSFSE see the expansion of the bowel to high signal; 2 cases Intestinal atresia congenital anal atresia, SSFSE dilatation of the intestine visible low signal meconium; 1 case of intestinal obstruction complicated by congenital esophageal atresia, SSFSE visible esophageal atresia high signal; 1 case of intestinal obstruction associated with diaphragmatic hernia, SSFSE coronal Hernia into part of the intestine, showing a little scattered in the left side of the chest high signal. Conclusion SSFSE MR examination can clearly show the congenital intestinal atresia, has some clinical diagnostic value.