Share：
Share this content in WeChat
X
[Chinese][PDF]128882
• Clinical Article •
The MRI diagnosis of fetal intestinal obstruction
ZHOU Li-xia  BU Jing-ying  GENG Zuo-jun  LI Haiyan  LIU Ci  LI Suo-lin 

DOI:10.12015/issn.1674-8034.2017.02.010.


[Abstract] Objective: To observe fetal intestinal obstruction with MRI, compared with the result of newborn surgery and pathology, explore the value of MRI in the diagnosis of fetal intestinal obstruction.Materials and Methods: Twenty-six cases of fetal intestinal obstruction were retrospectively analyzed, gestational age was 23—35 w, all cases were performed fetal ultrasound before fetal MRI. 4 MRI sequences were used including 2D FIESTA (2D fast imaging employ steady acquisition), SSFSE (single-shot fast spin echo), FIRM T1WI (fast inversion recovery motion insensitive T1WI) and DWI (diffusion weighted imaging). According to the intestinal obstruction sites, bowel signal changes, distal intestinal filling, and mesenteric vessels changes, radiological diagnosis was made, the secondary imaging signs such as ascites and amniotic fluid were also observed. Follow-up the fetal birth and surgical treatment postnatal , analysed the MRI accuracy and the missed diagnosis rate, and investigated the advantage of each sequence in the diagnosis of fetal intestinal obstruction.Results: In the 26 cases of fetal intestinal obstruction, 16 cases were duodenum/jejunum stricture or atresia with 4 cases accompanied duodenum and jejunum malrotation, 4 cases were small intestinal meconium obstruction with 2 cases secondary volvulus and ischemia necrosis, 4 cases were anal atresia, 1 case was colonic stricture or atresia and 1 case was congenital megacolon. All fetuses were associated with amniotic fluid in different degree, some cases with pleural effusion, pericardial effusion and hydrocele testis. 2 cases with single umbilical artery. MRI diagnostic accuracy rate was 92.3% (24/26), the misdiagnosis rate was 7.7% (2/26). MRI can locate the fetal intestinal obstruction and observe the extent of bowel dilatation. SSFSE can clearly show mesenteric vessels, FIRM T1WI is helpful to diagnosis of colonic ileus, DWI can detect obstruction ischemic bowel through the intestinal signal.Conclusion: Fetal intestinal obstruction has characteristic radiological imaging, the obstruction site and cause can be judged through fetal MRI as well as the complications, which has important reference value for prenatal diagnosis and postnatal surgical treatment.
[Keywords] Fetal diseases；Magnetic resonance imaging；Intestinal obstruction；Diffusion weighted imaging；Volvulus

ZHOU Li-xia* Department of Medical Imaging, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

BU Jing-ying Department of Medical Imaging, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

GENG Zuo-jun Department of Medical Imaging, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

LI Haiyan Department of the Seventh Gynecology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

LIU Ci Department of the Seventh Gynecology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

LI Suo-lin Department of Pediatric Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

*Correspondence to: Zhou LX, E-mail: doctorzhou@126.com

Conflicts of interest   None.

Received  2016-05-31
Accepted  2016-08-02
DOI: 10.12015/issn.1674-8034.2017.02.010
DOI:10.12015/issn.1674-8034.2017.02.010.

[1]
朱铭，董素贞．胎儿磁共振在产前诊断中的应用及适应症．中国实用妇科与产科杂志, 2015, 37(9): 822-825.
[2]
Veyrac C, Couture A, Saguintaah M, et al. MRI of fetal GI tract abnormalities. Abdominal Radiology, 2004, 29(4): 411-420.
[3]
鲁嘉，孟华，姜玉新，等．产前超声诊断胎儿肠道梗阻性病变．中国医学影像技术, 2010, 26(8): 1511-1513.
[4]
李姣玲，颜璨，耿秀平，等．消化道梗阻的产前超声诊断及围产期结局．中华临床医师杂志（电子版）, 2015, 9(20): 3714-3718.
[5]
Uzuki Z, Cho K, Honda S, et al. Atypical double-bubble in MRI of a fetus with double atresia involving esophagus and jejunum. Neonatal Biology, 2015, 4(3): 178.
[6]
耿娜，李索林，李英超，等．腹腔镜诊治新生儿先天性十二指肠梗阻．实用儿科临床杂志, 2011, 26(11): 833-835.
[7]
Westgarth-Taylor C, Westgarth-Taylor TL, Wood R, et al. Imaging in anorectal malformations: What does the surgeon need to know?. SA Journal of Radiology, 2015, 19(2): 903-913.
[8]
Carcopino X, Chaumoitre K, Shojai R, et al. Use of fetal magnetic resonance imaging in differentiating ileal atresia from meconium ileus. Ultrasound Obstet Gynecol, 2006, 28(7): 976-977.
[9]
朱铭．胎儿磁共振-磁共振检查的新领域.磁共振成像, 2011, 2(1): 7-12.
[10]
邹婵娟，李碧香，王友洁，等．先天性消化道畸形142例临床特征分析．中国新生儿科杂志, 2014, 29(4): 255-258.
[11]
Ionescu S, Andrei B, Oancea M, et al. Postnatal treatment in antenatally diagnosed meconium peritonitis. Chirurgia, 2015, 110(6): 538-544.
[12]
Uchida M, Koike Y, Matsushita K, et al. Meconium peritonitis: Prenatal diagnosis of rare entity and postnatal management. Intractable Rare Dis Res, 2015, 4(2): 93-97.
[13]
Schooler GR, Davis JT, Lee EY. Gastrointestinal tract perforation in the newborn and child: imaging assessment. Semin Ultrasound CT MR, 2016, 37(1): 54-65.
[14]
Perrone A, Savelli S, Maggi C, et al. Magnetic resonance imaging versus ultrasonography in fetal pathology. Radiol Med, 2008, 113(2): 225-241.
[15]
王军，胡晓华，王溧康，等．单次激发快速自旋回波序列MR检查在胎儿先天性肠道闭锁中的应用．临床放射学杂志, 2012, 31(3): 409-411.
[16]
孙子燕，夏黎明，王承缘，等.三维磁共振成像在检出胎儿结肠先天异常方面的应用．磁共振成像, 2010, 1(6): 442-447.
[17]
Colombani M, Ferry M, Garel C, et al. Fetal gastrointestinal MRI: all that glitters in T1 is not necessarily colon. Pediatr Radiol, 2010, 40(7): 1215-1221.

PREV The correlation between ADC value and DCE-MRI parameters of magnetic resonance imaging in different degree of differentiation of rectal cancer
NEXT Quantification of myocardial T1 mapping in minipig with chronic myocardial ischemia
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn