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胎儿肺部在MRI上的 序列探讨及临床应 用*

作者:黄健威 宋 亭 陈永露 刘照然 符立辉

所属单位:广州医科大学附属第三医院放射科 (广东 广州 510150)

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摘要

目的 探讨胎儿肺部在MRI上寻找 最佳的成像序列,研究胎儿肺部成像在 MRI中的临床应用。方法 对54例中、晚期 孕程的孕妇行SSh-T2WI及B-FFE扫描,评 价两序列在胎儿肺部的图像质量、模糊程 度、信噪比(SNR)及对比噪声比(CNR)等。 结果 在分级评价上SSh-T2WI序列在胎儿 肺部均获得较高评分。在定量分析上,正 常组胎儿左肺右肺在SSh-T2WI序列上分别 是(1.87±0.33)和(1.92±0.29),B-FFE 序列是(1.33±0.39)和(1.31±0.31)。病 变组胎儿左肺右肺在SSh-T2WI序列上分别 是(1.83±0.29)和(1.80±0.22),B-FFE 序列是(1.30±0.22)和(1.32±0.25)。胎 儿肺部与胎儿肝脏的CNR SSh-T2WI序列为 (1.68±0.8)比B-FFE序列(1.01±0.71)。 结论 在MRI检查中SSh-T2WI序列能够清晰 显示胎儿肺部及胎盘母体等的解剖结构, 获得的图像具有较高的图像对比度,可作 为胎儿肺部成像的首选序列。MRI能够清 晰准确显示胎儿肺部及周围脏器等的细微 结构,能直观、准确的诊断出胎儿呼吸系 统疾病。

Objective To explore the best imaging sequence of fetal lung in MRI, and to study the clinical application of fetal lung imaging in MRI. Methods SSh-T2WI and B-FFE scans of 54 pregnant women with middle and late pregnancy were performed to evaluate the image quality, blur degree, signal to noise ratio (SNR) and contrast noise ratio (CNR) of fetal lung in the two series. Results SSh-T2WI sequences obtained higher scores in fetal lungs in grading evaluation.In quantitative analysis, normal fetal left lung and right lung in the SSh-T2WI sequence were (1.87±0.33) and (1.92±0.29), (1.33±0.39) and B-FFE sequence is (1.31±0.31). The fetal left lung right lung in the lesion group was (1.83±0.29) and (1.80±0.22) on the SSh-T2WI sequence, and the B-FFE sequence was between (1.30±0.22) and (1.32±0.25). The CNR SSh-T2WI sequence of fetal lung and fetal liver was (1.68±0.8) than B-FFE's (1.01±0.71). Conclusion SSh-T2WI sequence in MRI examination can clearly show the anatomy of fetal lung and placenta of the obtained images with high image contrast, can be used as the preferred sequence of fetal lung imaging.MRI can clearly show the fine structure of fetal lungs and surrounding organs, can directly and accurately diagnosis of fetal respiratory system disease.

【关键词】MRI;胎儿;肺;SSh-T2WI; B-FFE

【中图分类号】R714.5

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.11.001

前言

随着MRI技术的发展,有研究表明胎儿在3.0T的MRI检查无副作 用[1],胎儿MRI还不受母体情况、胎儿骨骼及羊水量影响,对于孕晚期 胎头已入盆、羊水过少、双胎、过于肥胖孕妇显示效果较好。在超声 无法明确诊断的情况下,MRI将成为重要的辅助检查方法。在胎儿MRI 检查中,有多种成像序列,因孕妇的呼吸运动和胎动的影响,能把胎 儿肺部解剖结构清晰显示出来的成像序列尚无统一标准,目前在胎儿 成像中SSh-T2WI和B-FFE是使用较多的序列[2-3]。因此本文回顾性分析 SSh-T2WI和B-FFE两个序列在胎儿肺部的成像的比较及临床应用,初步 探讨MRI检查中SSh-T2WI在显示胎儿肺部及对诊断胎儿肺部异常病变的 体会及临床价值。