摘要
目的探讨MRI在诊断胎儿主动脉弓畸形中的价值。方法回顾性分析2013年3月至2014年10月产前超声检查提示有发育异常，然后行MRI检查，并经引产尸检和生后随访证实为主动脉弓畸形胎儿10例。重点观察MRI图像中主动脉弓位置及头臂动脉有无畸形，以及肝脏、胃腔在胎儿腹腔中的位置，腹部大血管毗邻关系等，并与产前超声和随访结果进行比较。结果10例胎儿中，MRI表现为右位主动脉弓（简称右弓）伴迷走左锁骨下动脉7例，其中1例还合并颈主动脉弓；右弓伴镜像分支1例，左位主动脉弓（简称左弓）伴迷走右锁骨下动脉1例，双主动脉弓1例。尸检和生后MRI随访与产前胎儿心脏MRI诊断均一致，产前超声诊断主动脉畸形漏诊5例，包括诊断右弓漏诊迷走左锁骨下动脉2例、镜像分支1例，诊断右弓伴迷走左锁骨下动脉漏诊颈主动脉弓1例，诊断左房异构漏诊左弓伴迷走右锁骨下动脉1例。此外，超声将1例双主动脉弓误诊为右弓伴迷走左锁骨下动脉。结论胎儿心脏MRI在诊断胎儿主动脉弓畸形中可作为超声的一种有效的补充检查手段。
Objective To explore the value of MRI in the diagnosis of fetal aortic arch anomalies. Methods We retrospectively collected 10 fetuses with aortic arch anomalies indicated by prenatal ultrasound and underwent MR examination and were subsequently proven by autopsy or post-birth follow-up from 320 pregnant women. We focused on the observations of the location of the aortic arch and brachiocephalic artery anomalies, the locations of the liver and stomach in the abdominal cavity, and the large vessels in abdomen. The above-mentioned finding were compared with prenatal ultrasound and follow-up findings. Results Of 10 cases, right aortic arch with aberrant left subclavian artery was seen in 7 cases, right aortic arch with the mirror branch, left aortic arch with aberrant right subclavian artery, right aortic arch with aberrant left subclavian artery combined with cervical aortic arch and double aortic arch was seen in 1 case, respectively. All aortic arch anomalies detected by MRI were consistent with post-birth or autopsy findings. Ultrasound misdiagnosed aortic branch malformation in 5 places, which included right aortic arch but misdiagnosed aberrant left subclavian artery in 2 cases, right aortic arch never diagnosed mirror branch anomaly in 1 case, right aortic arch with left subclavian artery misdiagnosed cervical aortic arch in 1 case, left atrial isomerism but misdiagnosed left aortic arch with aberrant right subclavian artery in 1 case; One double aortic arch was misdiagnosed as right aortic arch with aberrant left subclavian artery in ultrasound. Conclusion Fetal cardiovascular MRI is an effective and supplementary examination to complement ultrasound in diagnosis of fetal aortic arch anomalies.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2015年第9期694-697,共4页
Chinese Journal of Radiology
关键词
胎儿
主动脉
胸
血管畸形
磁共振成像
Fetus
Aorta,thoracic
Vascular malformations
Magnetic resonance imaging
