胎儿颌面颈部先天性囊性肿块的MRI诊断

摘要

目的：分析胎儿颌面颈部先天性囊性肿块的 MRI特点，提高产前胎儿影像诊断水平。方法：回顾性分析16例胎儿颌面颈部囊性肿块的 MRI表现，并与产后手术病理或尸检结果对照。结果：12例淋巴管畸形多表现为多房状，多数分布于颈后部，呈蔓延性生长，可跨中线，合并出血时囊内可见出血信号及液液平面。3例鳃裂囊肿均呈单囊，分布于颈前胸锁乳突肌前方，T1 WI呈低或稍低信号。1例鞍区的脑膜膨出疝入口腔内形成一巨大囊肿，与脑脊液信号一致。结论：MRI可以清晰显示胎儿颌面颈部先天性囊性肿块的轮廓、部位、形态、信号特点，有助于不同囊性肿块的鉴别。MRI 还能很好地显示气道有无压迫，为产时胎儿宫外处理提供更多信息。%Objective:To analyze the MRI features of congenital cystic masses in maxillofacial and neck region in fetu-ses,in order to improve prenatal imaging diagnostic level.Methods:MR images of 16 cases with congenital cystic masses in maxillofacial and neck region in fetuses were analyzed retrospectively,and were correlated with pathology or autopsy post-natally.Results:12 cases of lymphangioma predominantly presented as multilocular masses,centered in the posterior space of the neck,invasive,and could across the midline.Bleeding signals and fluid-fluid levels could be seen when there was intra-cystic hemorrhage.3 cases of branchial cleft cysts presented as unilocular masses,located in the neck anterior to sternoclei-domastoid,and could had low or slightly low signals on T1 WI.One case of cranial meningocele from sella area protruded to the oral cavity had equal signals with the cerebrospinal fluid.Conclusion:Prenatal MRI could display outline,locations, shapes and signal features of masses,which is helpful for the differentiation of different congenital cystic masses in maxillo-facial and neck region in fetuses.Moreover,MRI can reveal whether there is compression on the airway,which can provide more information for ex-utero intrapartum treatment.