摘要
目的评估 MRI 在胎儿泌尿系统畸形诊断中的价值。方法对34例泌尿系统畸形的胎儿 MRI 结果,结合超声诊断以及部分产后或术后结果进行分析。结果胎儿肾脏积水12例,包括7例随访积水消失;2例失访;产前 MRI 诊断的1例梗阻性右肾发育不良正在随访中,1例右双肾盂输尿管畸形在产后 MRI 随访中证实,1例肾盂输尿管连接处异常产后超声随访证实。双侧性泌尿系统畸形胎儿7例,显示羊水量减少,肺信号减低,其中双侧性多囊性肾发育不良3例(均引产),双肾发育不良2例(1例失访,1例尸检),双侧。肾不发育1例(引产后尸检证实),右肾缺如伴左肾发育不良1例(失访),1例尸检胎儿产前 MRI 诊断正确,1例 MRI 上清晰显示双侧下肢合并成团块状。单侧性泌尿系统畸形胎儿15例,包括单侧肾发育不良9例(3例随访中,2例引产,1例失访,3例产后超声或MRI 证实),单侧肾脏不发育4例(2例引产,2例产后超声或 MRI 证实),异位肾1例产后经超声证实,脐尿管囊肿1例引产,产前 MRI 对于得到随访结果的6例胎儿均诊断正确。结论 MRI 可以不受羊水量的影响,多方位清晰显示各类泌尿系统畸形及其伴发的其他系统畸形,并作出准确诊断,作为产前超声的重要补充检查手段具有很高的临床应用价值。
Objective To illustrate the important complemental function of MRI in dignosing the urinary abnormalities of the fetus by analyzing MR features. Methods MRI findings in 34 fetal urinary abnormalities were retrospectively analyzed. Results Upper urinary tract dilatation was found in 12 cases： one case presented obstructed right renal dysplasia and was on the follow-up, postnatal MR imaging proved the duplex anomaly in one case, one case showed left PUJO on postnatal US imaging and prepared to surgery, 7 cases were normal on postnatal US imaging, 2 cases were lost to follow up. Bilateral urinary anomalies were found in 7 cases： Multicystic renal dysplasia （ n = 3 ）, Combined horseshoe kidney in 2 fetuses and bilateral renal aplasia in one case. Bilateral renal dysplasia was diagnosed in 2 cases, one was still born and proved by autopsy and the ohter was lost to follow up. The case of bilateral renal agenesis displayed the appearance of sirenomelia on general specimen. The case of right renal agenesis associated contralateral kidney dyspalsia （ n = 1 ） was lost to follow up. MR imaging showed low signal intensity of lung and oligohydramnios in the bilateral anomalies. Unilateral urinary anomalies was found in 15 cases, including 9 cases of unilateral renal dysplasia. Two fetuses were aborted and 3 fetuses were proved with postnatal US or MR. One was lost to follow up; 3 cases were on the follow-up. There were 4 cases of unilateral renal agenesis, two fetuses were aborted and 2 fetuses were proved with postnatal US or MR imaging. The case of ectopic kidney was proved with postnatal US imaging. One case of urachal cyst was aborted without autopsy. In the unilateral anomalies, the volume of amniotic fluid was normal, and the fetal lung presented homogenious high signal intensity. Conclusion As a complemental method, MRI is of great value in displaying and dignosing the urinary abnormalities of fetus.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第11期1220-1223,共4页
Chinese Journal of Radiology
关键词
胎儿
磁共振成像
泌尿系统畸形
Fetus
Magnetic resonance imaging
Urinary anomalies
