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磁共振成像在胎儿侧脑室增宽中的应用进展

Research Progress in Magnetic Resonance Imaging of Fetal Ventriculomegaly

  • 摘要: 胎儿侧脑室增宽是产前影像学检查中常见的中枢神经系统疾病,预后有正常到严重功能障碍不等。目前仍缺少与产后个体神经发育功能相关的胎儿预测标志物,增加产前诊断和临床管理的难度。磁共振成像(magnetic resonance imaging, MRI)技术的不断进步使得其在侧脑室增宽诊断、预后评估及病因探索等方面更加准确和可靠,对预后管理和产前咨询具有重要作用。但受MRI的潜在安全隐患及经济、技术等限制,MRI不作为产前影像学诊断的首选,超声和MRI对胎儿侧脑室增宽的测量结果和分级仍存在争议。目前认为MRI测量三维体积可能为预后带来一些可靠信息,但精确分割测算脑结构是一个巨大的挑战,MRI测量侧脑室体积尚未达成共识。本文结合国内外最新研究综述MRI在产前侧脑室增宽应用中的进展,为进一步探究侧脑室体积测量在疾病诊断和管理中的作用提供理论基础,提出未来将二维宽度与三维体积结合,寻找胎儿侧脑室增宽的最佳预后预测截断值。

     

    Abstract: Fetal ventriculomegaly is a central nervous system disorder commonly seen in prenatal imaging, and the prognosis ranges from normal health to severe dysfunction. Currently, fetal predictive markers associated with postpartum individual neurodevelopmental function are still not available, which increases the difficulty of prenatal diagnosis and clinical management. Constant advancements in magnetic resonance imaging (MRI) technology have brought better accuracy and reliability of MRI applied in the diagnosis, prognosis assessment, and etiology investigation of ventriculomegaly. MRI plays a critical role in prognostic management and prenatal consultation. Nevertheless, due to the potential safety hazards and economic and technical constraints of MRI, it is not the first choice for prenatal imaging diagnosis. Moreover, there are different opinions regarding the measurement results and grading criteria of ultrasound and MRI. At present, it is accepted that three-dimensional volume may provide reliable information for prognosis. However, accurate segmentation and measurement of brain structure remain serious challenges, and no consensus on the MRI measurement of lateral ventricle volume has been reached. In this paper, based on the latest research reports from China and around the world, we reviewed the progress in applying MRI in the prenatal diagnosis and treatment of ventriculomegaly. This review offers a theoretical foundation for further exploration of the role of lateral ventricle volume measurement in disease diagnosis and management. We suggest that researchers combine two-dimensional width with three-dimensional volume in the future to identify the optimal cutoff value for prognostic prediction of fetal ventriculomegaly.

     

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