Ümit Aksoy ÖZCAN, Uğur IŞIK, Atilla DAMLACIK, Canan ERZEN

Fetal İnme Tanısında Prenatal MR Görüntüleme ve Önemi

Amaç: Bu çalışmada amacımız fetal inme tanısında ve etyolojisinin saptanmasında prenatal MR görüntülemenin katkısını değerlendirmektedir. Hastalar ve Yöntem: 2006 Ocak-2009 Aralık tarihleri arasında bölümümüzde yapılan 222 prenatal MRI olgusunun retrospektif olarak incelenmesinde fetal inme kriterlerine uyan toplam 8 olgu ortalama gestasyonel yaş 25.6 hafta 20-33 hafta saptanmıştır. Olgular 1.5T MR cihazında “receive only” vücut sarmalı ile annelere sedasyon uygulanmadan incelenmiştir. Görüntüler T2 ağırlıklı HASTE, FLASH 2D T1 ağırlıklı ve diffüzyon ağırlıklı sekanslarla elde edilmiştir. Bulgular: Toplam 8 fetusta %3.6 inme saptanmıştır. Bunların 6’sında %75 intraventriküler ve/veya germinal matriks kanaması saptanmıştır. Bir fetusta ikiz eşi ölümüne bağlı parietal lob yerleşimli kistik ensefalomalazi sahası gözlenmiştir, bir fetusta ise posterior fossada torkular herofili yerleşimli, tentorium ve vermisi iten, T2’de santrali hipointens dural sinus anevrizması ve eşlik eden hematoma bulgusu saptanmıştır. Bu gebeliklerden dördü sonlandırılmıştır. Sonuç: Prenatal MR görüntüleme fetal inme tanısı etyolojisini saptamak için önemlidir. Fetal dönemde erken tanınması terminasyon kararı veya doğurtulan hastalarda yakın nörolojik takip olasılığı sağlamaktadır.

The Value of Prenatal Mri Findings In The Diagnosis of Fetal Stroke

Aim: In this study our aim is to determine the value of prenatal MRI in the diagnosis of fetal stroke and its etiology. Patients and Methods: Two hundred twenty two fetal MRI’s which were referred to our center between 2006-2009 were retrospectively studied. Of these cases, 8 patients fulfilled the criteria of diagnosis of fetal stroke mean gestational age 25.6 weeks range 20-33 weeks . The patients were examined in a 1.5T MR scanner with “receive only” body coil without maternal sedation. The images were obtained by T2 weighted HASTE, FLASH 2D TSE, and diffusion weighted sequences. Results: Fetal stroke was diagnosed in 8 fetuses 3.6% . Out of 8 fetuses, 6 had 75% intraventricular and/or germinal matrix hemorrhage. One fetus had infarct after co-twin death and developed parietal lobe encephalomalacia, and one patient had a dural sinus aneurysm with central T2 hypointensity in posterior fossa located at torcular herophili a associated with hemorrhage. Four of these fetuses were terminated during pregnancy. Conclusion: Prenatal MRI is useful in the diagnosis of stroke and identification of the etiology in fetuses. Recognition of these abnormalities in early fetal life may result in termination of pregnancy or to undertake close follow-up of neurological status of those who are born alive.

Keywords:

fetal, stroke, MRI, prenatal,

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