摘要
目的探讨结节性硬化症(TCS)胎儿超声及磁共振成像(MRI)特征。方法对2013年7月至2014年12月在湖北省妇幼保健院产前超声、MRI检查及引产胎儿尸检和出生后随访证实为结节性硬化症10例胎儿的影像学特征进行分析。结果产前超声筛查的996例胎儿中超声显示心室内、心室壁近室间隔或心房内圆形或结节状均质高回声结节18例(单发4例,多发14例),均未发现脑部结节;18例胎儿中MRI显示心脏横纹肌瘤4例;脑部室管膜下结节10例,均呈T1WI稍高信号,T2WI低信号的小结节,自侧脑室壁突出于室管膜表面;其中合并脑皮质结节3例,表现为皮质及皮质下T2WI低信号病变,形态不规则。产前超声及MRI联合诊断胎儿结节性硬化症10例(心脏结节和颅内结节并存)。影像学检查后9例终止妊娠(2例尸检诊断胎儿心脏横纹肌瘤伴颅内结节),1例出生后随访诊断为结节性硬化症。结论产前超声易于显示胎儿心脏横纹肌瘤而不能显示颅内结节;MRI易于显示胎儿颅内结节但仅能显示部分心脏结节;超声与MRI联合检查优势互补,为明确诊断胎儿结节性硬化症提供更多影像学依据。
Objective To explore the imaging features of fetal tuberous sclerosis complex by ultrasonography and magnetic resonance imaging. Methods Retrospective analysis on the imaging characteristics of the 10 cases of fetuses confirmed as tuberous sclerosis complex who were examined in Hubei Maternal and Child Healthcare Hospital in July 2013 to December 2014 by ultrasonography and MRI, which was compared with the pathological data of specimens and follow-up after birth. Results Eighteen cases were diagnosed as fetal cardiac rhabdomyoma by ultrasonography among all of the 996 fetuses, in which lesions were located on the ventricular wall near septum or elsewhere in the heart cavity on ultrasonography. Fetal cardiac rhabdomyoma was characterized by circular, homogeneous high echo（singleton in 4 cases, multiple in 14 cases）. Among them no subependymal nodule was found by ultrasonographic. Ten cases of subependymal nodule were found by magnetic resonance imaging, which were diagnosed as tuberous sclerosis complex with cardiac rhabdomyomas, including 3 cases of brain subcortical tubers. The subependymal nodules under the lateral ventricle wall showed characteristic low signal nodules on T2 WI, protruding from the ependymal surface. Of 18 cases, only 4 cases of fetal cardiac rhabdomyoma were found by MRI. Nine cases of finally had termination of pregnancy. Two cases were confirmed as cardiac rhabdomyoma with intracranial nodules after pathological examination, and 1 case was confirmed as tuberous sclerosis complex after birth. Conclusions Prenatal ultrasonography can diagnose fetal cardiac rhabdomyoma successfully, and MRI can diagnose the fetal brain nodules sensitively. Once ultrasonography finds cardiac rhabdomyoma, it may be promising to diagnose fetal tuberous sclerosis complex by ultrasonography combined with MRI.
出处
《中华医学超声杂志（电子版）》
CSCD
2015年第11期884-888,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
湖北省自然科学基金(2011CDA012)
关键词
超声检查
产前
磁共振成像
胎儿
结节性硬化症
Ultrasonography
prenatal
Magnetic resonance imaging
Fetal
Tuberous sclerosis complex
