产前超声和磁共振联合诊断胎儿泄殖腔外翻综合征

摘要

Objective To investigate the value in the diagnosis of the OEIS(omphalocele,bladder ex-strophy,imperforate anus,spina bifida)complex by prenatal ultrasound combined MRI.Method This was a retrospective study of the nine cases with OEIS complex diagnosed at our center using detailed fetal ultrasound combined MRI since 2007.We summarized the fetal ultrasound and MRI findings that led to the diagnosis and compared them with the four of nine autopsy results.Results All affected fetuses were diagnosed using detailed fetal ultrasound and MRI.The main Prenatal imaging findings were omphalocele, skin-covered lumbosacral neural tube defect,non-visualized bladder and limb defects.Prenatal sonography and MRI failed to detect the abnormal genitalia and anal atresia.But MRI could point out bladder extro-phy,limb defects and one case of imperforate anus clearly.The all cases chose to terminate the pregnan-cies.Conclusions The characteristic of OEIS complex conclude ventral wall defect,spinal defect and a non-visualized bladder with or without limb defects.Diagnosis can be made by ultrasound and MRI.But MRI could support the diagnosis effectively by pointing out bladder extrophy,limb defects and imperforate anus clearly.%目的：探讨产前超声和 MRI联合诊断泄殖腔外翻综合征（脐膨出、膀胱外翻、肛门闭锁、脊柱裂）的临床价值。方法回顾性分析2007年以来9例胎儿系统超声和 MRI 联合诊断的泄殖腔外翻综合征胎儿，总结其各自支持诊断的影像学特征并与其中4例病理检查结果对照。结果所有胎儿系统超声和 MRI均能诊断泄殖腔外翻综合征，其主要的影像学特征是脐膨出、有皮肤覆盖的腰骶部神经管缺陷、不显示膀胱、肢体缺陷。超声和 MRI 均较难以显示生殖器的异常和肛门闭锁，但 MRI 能较明确提示膀胱外翻和肢体骨骼的异常及提示其中1例肛门闭锁。9例病例均终止妊娠。结论泄殖腔外翻综合征的特点是有腹壁缺损、脊柱缺陷、不显示膀胱和可能有肢体异常的影像学特征，超声和 MRI均能提示该诊断。MRI更能清晰显示膀胱外翻和脊柱异常从而更有力地支持泄殖腔外翻综合征。