目的:探讨MRI及超声对胎儿中重度肾积水的诊断价值.方法:搜集21例经产前超声和 MRI检查诊断为中重度肾积水胎儿的临床、影像及随访资料,将产前超声及MRI检查结果与产后随访结果或手术结果进行对照分析.结果:21例中,2例引产后经尸检证实;19例活胎娩出,其中16例经手术病理证实,余3例随访证实.产前超声诊断为中重度肾积水19例,腹腔内无回声1例,羊水过少1例.21例产前MRI均诊断为中重度肾积水.在中重度肾积水的原因判断中,超声检出正确9例,MRI检出正确15例.结论:产前超声可用于胎儿肾积水的筛查,而MRI能进一步明确肾积水的病因和严重程度,弥补超声检查的不足.%Objective: To assess and compare the diagnostic value of magnetic resonance imaging(MRI) and ultrasonography in moderate to severe hydronephrosis in fetuses. Methods: A total of 21 cases with moderate to severe hydronephrosis in fetus diagnosed by prenatal ultrasonography and MRI from April 2015 to October 2016 were collected. The prenatal imaging data with ultrasonography and MRI were correlated and compared with the postnatal follow-up results or surgical findings. Results; From the 21 cases, 2 cases were confirmed by autopsy after induced birth. There was normal birth in 19 cases, 16 of 19 cases were confirmed by surgery and pathology, and remaining 3 cases were confirmed by follow-up examination. In 19 cases of moderate to severe hydronephrosis diagnosed by prenatal ultrasound, there was no echo in one case and oligohydramnion in another case. In all 21 cases, prenatal MRI diagnosed as moderate to severe hydronephrosis. For determination of the etiology of the disease, ultrasound was corrcct in 9 cases and MRI was correct in 15 eases. Conclusion: As a convenient and noninvasive method, ultrasound plays a very important role in the screening of hydronephrosis. MRI as an auxiliary detection method, can further clarify the etiology and severity of hydronephrosis, to fill the lack of ultrasound, and also allow clinicians to intuitively understand the patient's condition, to provide a more appropriate basis for clinical diagnosis and treatment.
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