The value of MRI in the diagnosis of fetal esophageal atresia / 实用放射学杂志

ABSTRACT

Objective To explore the value of MRI in prenatal diagnosis of fetal esophageal atresia and to provide assistance for prenatal counseling.Methods A retrospective analysis of fetal MRI data of 1 1 cases due to ultrasound findings of hydramnios,small gastric vacuoles or unclear findings,and 22 to 3 5 gestational weeks was performed.MRI sequences included singleGshot fast spin echo (SShFSE),sequence and balanced fast field echo (BFFE),freedom cervical and thoracic cross,sagittal and coronal sectional scans, especially sagittal scans were used to observe fetal esophagus and trachea.Results In 1 1 cases prenatal ultrasound showed that the gastric cavities were small in 6 cases,not seen in 3 cases,and normal in 2 cases;5 cases of amniotic fluid increased,and 6 cases were normal;2 cases were diagnosed as susepected esophageal atersia by ultrasound.Eight patients were diagnosed as fetal esophageal atresia by MRI;one case was missed;two patients underwent MRI to show normal esophageal.9 cases of fetus were diagnosed as esophageal atresia by autopsy or postnatal examination.The MRI findings of fetal esophageal atresia showed that the upper esophagus was expanded in 6 cases,the esophagus was never showed in 3 cases,of which 1 case was missed by MRI,with the esophagus not shown,normal size of stomach bubble and normal amount of amniotic fluid.Among 11 cases,combined with cardiac macrovascular malformation in 4 cases;bilateral kidney volume decreased in 1 case;ventricular dilated in 3 cases;and single umbilical artery in 1 case.6 patients underwent induction of labor during followGup;4 patients were born successfully,including 2 patients undergoing surgery;2 patients with normal esophagus;and 1 patient with 40 weeks of fetal death.The accuracy of MRI in diagnosis of esophageal atresia was 88.9%.Conclusion Using repeated scanning of SShFSE and dynamic BFFE sequence,we can accurately observe fetal esophageal track.Fetal MRI is helpful in the diagnosis of fetal esophageal atresia,which can be used as a complement of prenatal ultrasound diagnosis method.