产前多序列3 T磁共振在诊断胎儿结节性硬化症中的应用价值

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摘要目的探讨多序列3 T磁共振在诊断胎儿结节性硬化症(TSC)疾病中的临床应用价值。方法回顾性分析本院产前超声诊断提示胎儿心脏横纹肌瘤可疑TSC孕妇42例,采用3 T磁共振进行胎儿颅脑扫描。扫描序列包括单次激发TSE(SSh-TSE)、平衡式快速场回波(B-FFE)、扩散加权成像(DWI)及T₁超快速场回波序列(T₁-TFE)序列。以引产尸检结果及生后随访为金标准,分析磁共振及超声图像,比较两者之间优缺点,记录扫描时各序列特异性吸收率(SAR)值。结果 42例磁共振胎儿颅脑可疑患者中,磁共振诊断结节性硬化症19例,包括室管膜下异常信号18例,脑皮层异常信号5例,白质异常2例,室管膜下星形细胞瘤2例,磁共振图像表现为SSh-TSE与B-FFE低信号,DWI与T₁-TFE呈高信号。42例可疑患者中,超声诊断心脏横纹肌瘤42例,颅内异常信号4例。最终引产尸检结果及生后随访诊断结节性硬化症19例,其中5例行基因检查,5例TSC2基因突变。结合金标准,磁共振确诊结节性硬化症16例,3例确诊TSC而磁共振显示颅内正常。结论胎儿结节性硬化症与心脏横纹肌瘤呈伴行关系,产前超声诊断心脏横纹肌瘤时,需借助磁共振诊断颅内有无结节及皮质异常,及时早期确诊结节性硬化症,为产前诊断在胎儿结节性硬化症疾病中提供影像学技术保障。

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	李鸿恩
	谭健彬
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	袁灿桃
	曾益辉

关键词 ： 3 T磁共振, 结节性硬化症, 心脏横纹肌瘤

收稿日期: 2022-11-11

ZTFLH:

R71

通讯作者: 曾益辉(710171607@qq.com)

引用本文:

李鸿恩, 谭健彬, 李悦龙, 袁灿桃, 曾益辉. 产前多序列3 T磁共振在诊断胎儿结节性硬化症中的应用价值[J]. 中国生育健康杂志, 2023, 34(6): 553-557.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2023/V34/I6/553

1 Hallett L,Foster T,Liu Z,et al.Burden of disease and unmet needs in tuberous sclerosis complex with neurological manifestations:systematic review.Curr Med Res Opin,2011,27:1571-1583.
2 刘雪芹.心脏横纹肌瘤与结节性硬化症.中华儿科杂志,2014,52:234-237.
3 鲁才娟,鲁建央,詹欣,等.心脏横纹肌瘤胎儿基因检测对诊断结节性硬化症的价值.浙江医学,2020,42:583-586.
4 陈健,谷孝艳,韩玲,等.38例胎儿心脏肿瘤的超声、病理及遗传学特点分析.中西医结合心脑血管病杂志,2020,18:3318-3322.
5 Savelli S,Di Maurizio M,Perrone A,et al.MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) assessment in the evaluation of normal and abnormal fetal kidneys:preliminary experience.Prenat Diagn,2007,27:1104-1111.
6 Northrup H,Krueger DA.Tuberous sclerosis complex diagnostic criteria update:recommendations of the 2012 Iinternational Tuberous Sclerosis Complex Consensus Conference.Pediatr Neurol,2013,49:243-254.
7 Roth J,Roach ES,Bartels U,et al.Subependymal giant cell astrocytoma:diagnosis,screening,and treatment.Recommendations from the International Tuberous Sclerosis Complex Consensus Conference 2012.Pediatr Neurol,2013,49:439-444.
8 吕国荣.胎儿颅脑和心脏畸形超声诊断.北京:北京大学医学出版社,2010.
9 Atalay S,Aypar E,Uçar T,et al.Fetal and neonatal cardiac rhabdomyomas:clinical presentation,outcome and association with tuberous sclerosis complex.Turk J Pediatr,2010,52:481-487.
10 Chen CP,Su YN,Chang TY,et al.Prenatal diagnosis of rhabdomyomas and cerebral tuberous sclerosis by magnetic resonance imaging in one fetus of a dizygotic twin pregnancy associated with a frameshift mutation in the TSC2 gene.Taiwan J Obstet Gynecol,2010,49:387-389.
11 刘颖,袁慧书.常见双胎妊娠合并症的脑部 MR 征象分析及序列对比研究.实用放射学杂志,2014:1336-1340.
12 曾旭,周芷溪,董国礼,等.正常中晚孕胎儿侧脑室大小随胎龄变化的初步探讨.实用放射学杂志,2014:983-986.
13 黄卫保,林剑军,马慧,等.胎儿结节性硬化症的影像学特征分析.中国妇幼保健,2019,34:4092-4094.
14 郑淋,金兰中,王芳韵,等.小儿心脏横纹肌瘤的超声心动图诊断及分析其与结节性硬化症的关系.中国超声医学杂志,2012,28:817-819.
15 Chang KJ,Kamel IR,Macura KJ,et al.3.0-T MR imaging of the abdomen:comparison with 1.5 T.Radiographics,2008,28:1983-1998.
16 贾凤林,曲海波.胎儿脑部MR成像T1加权序列的临床应用进展.中国临床医学影像杂志,2019,30:511-513.
17 Roach ES,Gomez MR,Northrup H.Tuberous sclerosis complex consensus conference:revised clinical diagnostic criteria.J Child Neurol,1998,13:624-628.
18 Yinon Y,Chitayat D,Blaser S,et al.Fetal cardiac tumors:a single-center experience of 40 cases.Prenat Diagn,2010,30:941-949.
19 Hand JW,Li Y,Thomas EL,et al.Prediction of specific absorption rate in mother and fetus associated with MRI examinations during pregnancy.Magn Reson Med,2006,55:883-893.