Comparative Study Of Ultrasound And Magnetic Resonance Imaging In Fetuses With Nervous System Abnormalities

Objective To comparative study the clinical value of prenatal ultrasound (US) and magnetic resonance imaging(MRI) in fetuses with nervous system abnormalities. To explore the relationship between fetuses with nervous system abnormalities and fetal chromosomal abnormalities; To investigate outcome and clinical prognosis of fetal nervous system abnormalities.Method (1)To prospective choose with fetal nervous system abnormalities by US,101fetuses as the study group received MRI examination within48hours after US. the results of US and MRI diagnosis were compared.(2) The interventional prenatal diagnosis were implemented with indications.(3) For the case with chose to continue in study group, to regularly follow-up the intrauterine outcome,he pregnancy outcome,he situation of fetal nervous system development after born, and to assess the development status of the nervous system in infants by using DQ scoring of the Gesell infant development scale in28weeks after birth.Results (1)MRI gave extra and important diagnostic information22cases (21.8%);MRI changed the diagnosis27cases (26.7%), in59of cases, the abnormal development of fetus’brain,10cases; the intracranial arachnoid cyst,6cases; the intracranial hemorrhage,5cases;the gyral or sulci malformation,5cases;corpus callosum,3cases;lesions in the surrounding brain tissue abnomal7cases.(2)59cases of pregnant women were subjected to fetal karyotype analysis.2cases fetus of trisomy21,1case fetus of trisomy18. Chromosomal abnormalities were detected in5.1%(3/59)(3) In case of19ILVM, the mild LVW resolved throughout pregnancy in71.4%(5/7),no progress; moderate LVM progressed in33.3%(4/12). In birthed infants,DQ of88.9%(8/9) the mild LVM cases were normal; In moderate LVM group, lcases was confirmed with moderate retardation; In severe LVM group,1cases was confirmed with cerebral palsy. The cisterna magna enlargement9cases, progressed in22.2%(2/9),8cases fetal were birthed,85.7%(6/7) the prognosis is good.8cases with intracranial cystic placeholder of intrauterine outcome were good or stable, among of them, because of adjacent brain tissue pathological changes,3cases infants happened stunting or epilepsy. Isolation of choroid plexus cyst and cavum septum pellucidum(CSP) abnormalities have good prognosis and uterus outcome.4cases of Smaller head circumference in intrauterine were stable.2cases was confirmed with mild retardation.12cases found late developer were timely rehabilitation treated,5cases were improved,7cases in therapy.Conclusion (1) MRI has important clinical value for the intracranial hemorrhage and the position of intracranial arachnoid cyst,corpus callosum.Lob-Holoprosencephaly the abnormal development of fetus’ brain,the gyral or sulci malformation,lesions in the surrounding brain tissue abnomal.when abnormal or suspicious anomaly by US, we should be to recommended MRI examination for pregnant women, after28pregnancy weeks.(2) Fetal karyotype analysis should be processed as early as possible. For third trimester pregnancy, FISH check can be used as a remedy way.(3)The mild LVM, the mild cisterna magna enlargement, choroid plexus cysts, CSP enlargement have more benign outcome and their prognosis are good. The moderate or severe LVM and the cisterna magna enlargemen,Smaller head circumference often present bad outcome, In moderate LVM group,1cases w Part of the case can appear development retardation, even cerebral palsy. Intrauterine outcome of arachnoid cyst is more stable, mainly related with prognosis is the location and its adjacent brain tissue disease. It is crucial to regular follow up, early detection, early intervention with nervous system abnormalities for poor prognosis to good prognosis.as confirmed with moderate retardation; in severe LVM group,1cases was confirmed with cerebral palsy.