Prenatal MRI assessment of fetal congenital high airway obstruction syndrome / 中华放射学杂志

Objective To investigate the manifestation and diagnostic value of the congenital high airway obstruction syndrome(CHAOS)in fetal MRI.Methods Prenatal fetal MRI images were reviewed in 9 fetuses from February 2014 to February 2017 which were screening by ultrasound and underwent MR examination within 2 days. Scanning sequence included HASTE, True-FISP, T2WI、T1WI and DWI sequence. If found suspicious airway obstruction, the fetus will be add the sequence in coronal planes. Prenatal US and MR imaging findings were compared with specimen MR imaging and pathological results. Results All the fetuses viewed demonstrated the following MRI findings:bilateral lung volume increased, increased lung signal on T2WI, dilated airway below the lever of obstruction, flattened or inverted hemidiaphragms,centrally positioned and compressed heart.Ascites and anasarca could be find in 8 cases. Prenatal MRI identified the level of obstruction was 5 cases in laryngeal and 4 cases in tracheal.Four cases of laryngeal obstruction and 3 cases of tracheal obstruction were finally confirmed by autopsy.One case died in intrauterine,and the other 1 case was lost to follow-up.Conclusion MRI shows a special performance in fetals with CHAOS,accurately identifies the level of airway obstruction,and can provide help for perinatal management.

The value of ultrasound and MRI in the diagnosis of pulmonary sequestration / 中华医学超声杂志（电子版）

Objective To investigate the diagnostic value of ultrasound and MRI in fetal bronchopulmonary sequestration (BPS). Methods The 7 pregnant women with suspected fetal BPS were examined with a 1.5 T MR unit within 24 h after prenatal ultrasound in Hubei Maternal and Children's Hospital during July 2013 to February 2015. The imaging protocol included half-fourier acquisition single shot turbo SE (HASTE), true fast imaging with steady state precession (True FISP) in axial, frontal and sagittal planes relative to the fetal thorax. Prenatal MRI findings have been compared with postnatal enhanced computed tomography or biopsy. Results The locations of BPS were in left side in 5 cases and in right side in 2 cases. One case was complicated with congenital cystic adenomatoid malformation (CCAM) of lung. Ultrasound showed the intrathoracic mass as a hyperechoic lesion and the feeding artery could be found by Doppler ultrasonography. T2WI could reveal not only the hyperintense lesions with clear boundary, but also the hypointense feeding artery originating from systemic circulation. Compared with pathological examination or enhanced CT, both of the ultrasound and the MRI could locate the lesions;however 2 feeding arteries were misjudged. Conclusions Prenatal ultrasound is the first-choice diagnostic modality for BPS. MRI can demonstrate the location, morphology and the feeding arteries of the fetal BPS, and also estimate the volume of normal lungs, which could be an important supplement to prenatal ultrasound in prenatal diagnosis and prognostic prediction of BPS.

The role of prenatal ultrasound and MRI in diagnosis of fetal agenesis of corpus callosum / 中华医学超声杂志（电子版）

Objective To discuss the value of prenatal ultrasound and MRI in diagnosis of fetal agenesis of corpus callosum (ACC). Methods Sixty-seven fetuses from Hubei Maternal and Children's Hospital performed fetal MRI from July 2013 to December 2014 were included in this study. All fetuses (67 cases) with suspected ACC were studied with a 1.5T MR unit within 3 days after ultrasound examination. Prenatal ultrasound and MRI findings were studied. Results All the 67 ACCs previously suspected on ultrasound were confirmed by MRI. Among the 67 ACCs, 58 cases were complete ACC and 9 cases were partial ACC. Corpus callosum body and/or splenium absence was found in all 9 partial ACC cases. In all cases, on MRI, corpus callosum complete or partial absence was showed on the median sagittal images, and mild to moderate ventriculomegaly and abnormal morphology in lateral ventricle was shown on the axial or coronary images. Conclusions MRI has high value in diagnosis of ACC. When ACC is found or suspected by ultrasonophy, MRI examination is suggested to confirm the diagnosis.

Prenatal diagnosis of fetal tuberous sclerosis complex with ultrasonography and magnetic resonance imaging / 中华医学超声杂志（电子版）

ObjectiveTo explore the imaging features of fetal tuberous sclerosis complex by ultrasonography and magnetic resonance imaging.MethodsRetrospective analysis on the imaging characteristics of the 10 cases of fetuses confirmed as tuberous sclerosis complex who were examined in Hubei Maternal and Child Healthcare Hospital in July 2013 to December 2014 by ultrasonography and MRI, which was compared with the pathological data of specimens and follow-up after birth.ResultsEighteen cases were diagnosed as fetal cardiac rhabdomyoma by ultrasonography among all of the 996 fetuses, in which lesions were located on the ventricular wall near septum or elsewhere in the heart cavity on ultrasonography. Fetal cardiac rhabdomyoma was characterized by circular, homogeneous high echo (singleton in 4 cases, multiple in 14 cases). Among them no subependymal nodule was found by ultrasonographic. Ten cases of subependymal nodule were found by magnetic resonance imaging, which were diagnosed as tuberous sclerosis complex with cardiac rhabdomyomas, including 3 cases of brain subcortical tubers. The subependymal nodules under the lateral ventricle wall showed characteristic low signal nodules on T2WI, protruding from the ependymal surface. Of 18 cases, only 4 cases of fetal cardiac rhabdomyoma were found by MRI. Nine cases of ifnally had termination of pregnancy. Two cases were conifrmed as cardiac rhabdomyoma with intracranial nodules after pathological examination, and 1 case was conifrmed as tuberous sclerosis complex after birth. ConclusionsPrenatal ultrasonography can diagnose fetal cardiac rhabdomyoma successfully, and MRI can diagnose the fetal brain nodules sensitively. Once ultrasonography finds cardiac rhabdomyoma, it may be promising to diagnose fetal tuberous sclerosis complex by ultrasonography combined with MRI.

Establishment of Rabbit VX2 Soft Tissue Tumor Model and Treatment with Percutaneous Ethanol Inj ection under the Guidance of Magnetic Resonance Imaging / 实用放射学杂志

Objective Establish rabbit VX2 soft tissue tumor model,and treat it with percutaneous ethanol injection(PEI)under the guidance of magnetic resonance imaging.Make ready for the therapeutic evaluation with functional magnetic resonance imaging. Methods Fifteen healthy New Zealand white rabbits were included in this study.0.2 mL tumor tissue suspensions were injected into the rabbits’posterior limb.14 days later,all rabbits were underwent conventional MRI examination.PET were performed to all the tumors under the guidance of MRI in the next day of the examination.T2 WI was used as guidance and monitoring means.MR com-patible puncture needle with lateral hole was stabed into the lesion center,and inj ected anhydrous ethanol according to the volume of tumors’diameter (1 mL/cm )slowly.the tumors signal characteristics,morphological feature and pathological feature were ob-served pre and post-operation.Results All of the 1 5 rabbits were established soft tissue tumor model successfully;the success rate is 100%.The tumors were oval or round,3-4 cm in diam.MRI scanning showed low signal on T1 WI and high signal on T2 WI be-fore PEI.PEI was performed to all the tumors under the guidance of MR successfully with 3.5 mL ethanol injected into the tumors in average.T2 WI could monitor the ethanol in dispersion and distribution within the tumors clearly.Histologically,tumors were composed of large,uniform,oval/round cells arranged in solid nests which was intensive in the periphery of tumors.Necrosis tissue was apparent in the center of the tumors.10 days after operation,most tissue in the periphery of tumors was coagulative necrosis , only a few tumor cells left.Ranges of necrosis in the tumors center were obviously increased compared with pre-operation.Conclusion Rabbit VX2 tumor of soft tissue model is suitable for the therapeutic evaluation of tumor .It is an animal model which has the characteristic of simple to operate and high rate of suc-cessful.MR T2 WI can monitor the ethanol in dispersion and distribution within the tumors clearly.It is a good guidance and monitoring imaging method of tumor ablation.

Interventional Therapy for Cervical Gestation / 实用放射学杂志

Objective To explore the function of chemotherapy and embolization of uterine artery in treating cervical gestation.Methods 11 cases with cervical gestation were emergently undergone intubation in bilateral uterine arteriae,then the perfusion of Methotrexate was performed through the catheters,after that,the embolization of bilateral uterine arteriae was carried out with grains of gelatin sponge.The uterine aspiration or curettage was carried out under B-ultrasound guided within a week.Results Chemotherapy and embolization of uterine artery were successfully executed in all cases.Within a week,the uterine aspiration or curettage was done smoothly with little hemorrhage in the process of the operation.Conclusion Chemotherapy and embolization of uterine artery provides the secure guarantee for the conservative treatment of patients with cervical gestation,and it's a kind of safe effective therapy.