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目的:探讨胎儿结节性硬化症(TSC)的产前MRI诊断方法及影像特征。方法:回顾性分析产前MRI联合超声诊断为TSC的14例胎儿资料,并总结其影像特征。MRI主要采用快速成像即HASTE序列及DWI序列,部分胎儿结合T1WI(FL2D)扫描。结果:产前超声筛查发现心脏横纹肌瘤胎儿共22例,MRI检查发现14例胎儿脑部见室管膜下结节,5例同时合并脑皮质结节。14例胎儿均诊断为TSC。胎儿脑部结节表现为T1WI稍高信号,HASTE序列低信号结节,以HASTE序列显示最佳。本组14例TSC胎儿9例终止妊娠引产,其中2例引产后标本解剖病检,证实为心脏横纹肌瘤伴颅内结节;5例出生后随访证实为TSC。结论:产前超声检查可准确诊断胎儿心脏横纹肌瘤。超声提示心脏横纹肌瘤后,MRI对诊断胎儿TSC颅脑病变敏感性高。MRI联合超声可以确诊胎儿TSC。
Objective: To investigate prenatal MRI diagnosis and imaging features of fetal tuberous sclerosis (TSC). Methods: A retrospective analysis of prenatal MRI combined with ultrasound diagnosis of TSC in 14 cases of fetal information, and summarizes the image features. The main use of rapid imaging MRI HASTE sequence and DWI sequences, part of the fetus with T1WI (FL2D) scan. Results: Twenty-two cases of fetal rhabdomyosarcoma were found by prenatal ultrasound screening. MRI findings revealed 14 cases of fetal brain subventricular nodules and 5 cases of cerebral cortex nodules. All 14 fetuses were diagnosed as TSC. Fetal brain nodules showed slightly higher T1WI signal, HASTE sequence low signal nodules, HASTE sequence showed the best. The group of 14 TSC fetuses termination of pregnancy induced abortion in 9 cases, of which 2 cases of post-partum anatomy examination, confirmed as rhabdomyosarxoma with intracranial nodules; 5 cases were confirmed after follow-up TSC. Conclusion: Prenatal ultrasound can accurately diagnose fetal cardiac rhabdomyoma. Ultrasound prompts cardiac rhabdomyoma, MRI is sensitive to the diagnosis of fetal TSC craniocerebral lesions. MRI combined with ultrasound can confirm fetal TSC.