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• 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.

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