Application of MR in prenatal screening of fetal digestive tract
10.3969/j.issn.1002-1671.2024.06.016
- VernacularTitle:MR在胎儿消化道产前筛查中的应用
- Author:
Liming CHANG
1
;
Lili SHI
;
Guangmin LI
Author Information
1. 唐山市工人医院放射科,河北 唐山 063000
- Keywords:
fetus;
digestive tract;
magnetic resonance imaging
- From:
Journal of Practical Radiology
2024;40(6):931-935
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application value of MR in prenatal screening of fetal digestive tract diseases.Methods A total of 36 fetuses who underwent abdominal MR examination were analyzed retrospectively.The data of gastrointestinal abnormalities were compared with postnatal surgery or follow-up results respectively.The characteristics of MR images were summarized,including whether the intestines movement was normal,the signal characteristics of the dilated intestinal cavity,the shape of the obstruction site of the dilated intestines,and whether there was ascites.Results Of the 36 fetuses,there were 6 cases with jejunum obstruction,2 cases with ileum obstruction,2 cases with volvulus necrosis,2 cases with colonic obstruction,8 cases with colon slightly widened due to meconium accumulation in late pregnancy diagnosed correctly via MR,3 cases with esophageal atresia,1 case with misdiagnoses,13 cases with duodenal obstruction,and 1 case with missed diagnosis.A total of 34 cases were diagnosed correctly via MR,with a diagnostic accuracy of 94.44％(34/36).The 6 cases with jejunum obstruction were all located in the left upper abdomen of the fetus,showed tortuous and dilated intestines in the middle and upper abdomen,with high signal on the T2 WI and low signal on the T1 WI in the intestinal cavity.Two cases with ileum obstruction were all located in the right middle and lower abdomen,showed that the dilated intestines near the obstruction point was slightly higher on the half-fourier acquisition single-shot turbo spin-echo(HASTE)-T2WI and T1 WI,and the colon was small.Two cases of colonic obstruction showed significant expansion of the transverse colon,with low signal on the HASTE-T2WI and high signal on the T1 WI in the intestinal cavity.The intestinal canal of 2 cases with volvulus necrosis was out of shape,with dilated and shrunken intestinal cavity and twisted mass,showed high signal on diffusion weighted imaging(DWI),and a large amount of fluid was in the abdominal cavity.Three cases with esophageal atresia showed cystic dilation in the upper and middle segments of the esophagus,without high signal gastric vesicles on the T2 WI and with empty and collapsed small intestinal cavity.One case showed esophageal patency via postnatal imaging.The"double bubble sign"was found in 13 cases with duodenal obstruction diagnosed by MR.One case was misdiagnosed due to the influence of motion artifact,resulting in poor display of anal region structure.Conclusion MR can not only determine the location of fetal gas-trointestinal dysplasia via the characteristics and location of dilated intestinal cavity signals,but also analyze the cause of obstruction.Jejunum atresia is prone to intestinal malrotation,and DWI sequence is beneficial for evaluating intestinal wall ischemia.
