CAJ | 학술논문

目的：探讨胎儿结节性硬化症（TSC）的产前 MRI 诊断方法及影像特征。方法：回顾性分析产前 MRI 联合超声诊断为 TSC 的14例胎儿资料，并总结其影像特征。MRI 主要采用快速成像即 HASTE 序列及 DWI 序列，部分胎儿结合 T1 WI （FL2D）扫描。结果：产前超声筛查发现心脏横纹肌瘤胎儿共22例，MRI 检查发现14例胎儿脑部见室管膜下结节，5例同时合并脑皮质结节。14例胎儿均诊断为 TSC。胎儿脑部结节表现为 T1 WI 稍高信号，HASTE 序列低信号结节，以 HASTE 序列显示最佳。本组14例 TSC 胎儿9例终止妊娠引产，其中2例引产后标本解剖病检，证实为心脏横纹肌瘤伴颅内结节；5例出生后随访证实为 TSC。结论：产前超声检查可准确诊断胎儿心脏横纹肌瘤。超声提示心脏横纹肌瘤后，MRI 对诊断胎儿 TSC 颅脑病变敏感性高。MRI 联合超声可以确诊胎儿 TSC。
목적：탐토태인결절성경화증（TSC）적산전 MRI 진단방법급영상특정。방법：회고성분석산전 MRI 연합초성진단위 TSC 적14례태인자료，병총결기영상특정。MRI 주요채용쾌속성상즉 HASTE 서렬급 DWI 서렬，부분태인결합 T1 WI （FL2D）소묘。결과：산전초성사사발현심장횡문기류태인공22례，MRI 검사발현14례태인뇌부견실관막하결절，5례동시합병뇌피질결절。14례태인균진단위 TSC。태인뇌부결절표현위 T1 WI 초고신호，HASTE 서렬저신호결절，이 HASTE 서렬현시최가。본조14례 TSC 태인9례종지임신인산，기중2례인산후표본해부병검，증실위심장횡문기류반로내결절；5례출생후수방증실위 TSC。결론：산전초성검사가준학진단태인심장횡문기류。초성제시심장횡문기류후，MRI 대진단태인 TSC 로뇌병변민감성고。MRI 연합초성가이학진태인 TSC。
Objective:To explore the imaging features of fetus tuberous sclerosis complex by using ultrasonographyand MRI.Methods:Fourteen 1 4 cases of fetuses who were confirmed as tuberous sclerosis complex by MRI and ultrasonographywere retrospectively analyzed,and the imaging characteristics of the 1 4 fetuses were summarized.MRI adopted fastimaging consisting of HASTE sequence and DWI sequence,part of scans being in combination with T1 WI (FL2D)sequence. Results:Twenty-two cases were diagnosed as fetal cardiac rhabdomyoma by ultrasonography,in which,1 4 cases werefound with subependymal nodules by magnetic resonance imaging,they were all diagnosed as having tuberous sclerosis complexcombined with cardiac rhabdomyomas,including 5 cases which revealed brain subcortical noduls meanwhile.Fetal brainnodules revealed slightly higher signal on T1 WI and low signal on HASTE sequence.They were best shown on HASTE sequence.Nine cases of the 1 4 had a termination of pregnancy,2 cases of specimens after abortion were confirmed to have cardiacrhabdomyoma with intracranial nodules after anatomic inspection,5 cases were confirmed for tuberous sclerosis complexafter birth.Conclusions:Prenatal ultrasonography can diagnose fetal cardiac rhabdomyoma successfully,MRI can diagnosefetal brain nodules with high sensitivity.Once ultrasonography finds cardiac rhabdomyoma,it is easy to diagnose fetaltuberous sclerosis complex by MRI combined with ultrasonography.