ABSTRACT
Objective:To evaluate the value of MRI in the diagnosis of jejunal and ileal atresia in fetus.Methods:This study included thirteen neonates with surgically and pathologically confirmed jejunal or ileal atresia without other gastrointestinal diseases treated in our institution between January 1, 2010 and December 31, 2018. MRI was performed on all fetuses subsequent to routine prenatal sonographic examinations indicated bowel dilation or ascites. MR images were analyzed by two radiologists,and MRI diagnosis was compared with surgical and pathological results.Results:On prenatal MRI, eight fetuses exhibited single or multiple dilated small bowel loops, one of them exhibited a cystic mass in the abdomen; five fetuses exhibited massive ascites, and collected bowels. On final surgical and pathological diagnosis, nine fetuses had ileal atresia, five of them had intestinal perforation; four fetuses had jejunal atresia, one of them had intestinal perforation and a meconium pseudocyst. Among the 7 cases without intestinal perforation, the atresia location was diagnosed correctly in 5 cases. The 6 fetuses with intestinal perforation were diagnosed as intestinal atresia and meconium peritonitis by prenatal MRI, but the location of atresia could not be determined.Conclusions:Jejunal and ileal atresia have their characteristic manifestations on prenatal MRI. The location of atresia can be inferred from the distribution of amniotic fluid and meconium in the intestine. Prenatal MRI has a complementary role in the assessment of fetal bowel abnormalities after standard obstetric ultrasound.
ABSTRACT
Objective To explore the value of MRI in diagnosis of fetal meconium peritonitis.Methods Seven meconium peritonitis fetuses proved by surgery and pathology were enrolled.The prenatal MRI findings and clinical data were analyzed retrospectively.Results Six fetuses showed a large amount of ascites,intestinal tube floating in the abdomen,small intestine gathered together.One fetus showed a giant abdominal cystic mass,with bowel compressed,displaced and uneven dilated.Four fetuses showed small colon and rectum,or without meconium signal.Two fetuses were accompanied by bilateral hydrocele.Amniotic fluid increased in 3 cases.After the neonates were born,1 case of them died from sudden heart rate decline during operation,1 case died from severe pulmonary edema after operation,and 5 cases survived after operation.Conclusion MRI has some features in the prenatal diagnosis of meconium peritonitis,which can provide an important basis for postpartum treatment and evaluation of prognosis.