Obstetric and Gynecologic Ultrasound
The prenatal ultrasound and magnatic resonance imaging characteristics of fetal intracranial hemorrhage
Jin Han, Sihui Zeng, Li Zhen, Xin Yang, Min Pan, Hongsheng Liu, Dongzhi Li, Jie Bai, Yimin Yu, Changping Dai, Can Liao
Published 2015-05-01
Cite as Chin J Med Ultrasound(Electronic Edition), 2015, 12(5): 383-389. DOI: 10.3877/cma.j.issn.1672-6448.2015.05.011
Abstract
ObjectiveTo investigate the diagnostic value of prenatal ultrasonography and magnatic resonance imaging in the fetal intracranial hemorrhage.
MethodsThe 20 antenatal diagnosed ICH cases was collected from 31 200 prenatal diagnosis units in Guangzhou Women and Children′s Medical Center from July 2012 to June 2014. Maternal characteristics, ultrasound, and magnetic resonance imaging findings, clinical course, and postnatal outcome were reviewed.
ResultsTwenty consecutive cases of fetal ICH were evaluated. All cases were diagnosed at mid or third trimester. Transabdominal ultrasound showed 9 cases of hyper echoic lesions in the lateral ventricle, 2 cases of hypoechonic lesions, 2 cases of irregular mixed echo in the parenchyma, 1 case of hyperechoic cerebellar hemisphere with infarction, and 1 case of abnormal choroid plexus. Seventeen cases were associated with ventriculomegaly, brain compression or brain midline displacement. MRI showed the nodular, patchy or linear low signal on T2WI and high signal on T1WI. Some cases were combined with cortex lesions or abnormal parenchyma. ICH was complicated with other structural abnormalities: 1 case of cleft palate, 2 cases of spinal deformity and 3 cases of other cerebral cortical malformations. Prenatal diagnosis results were: 2 cases diagnosed as positive cytomegalovirus infection and no chromosome abnormalities found in all cases. The follow up results were: 1 case was lost, 16 cases were terminated after prenatal diagnosis. Among the 3 survival cases, 1 case has the neurological complication and the other two were normal till now.
ConclusionsFetal intracranial hemorrhage has some image features on ultrasound and magnetic resonance. Ultrasound showed hyper echoic lesions with ventriculomegaly. MRI showed the nodular, patchy or linear low signal on T2WI and high signal on T1WI. MRI may contribute to the accuracy of diagnosis, particularly in bleeding site. The regular ultrasonic monitoring is helpful to improve the detection rate.
Key words:
Ultrasonography, prenatal; Magnetic resonance imaging; Intracranial hemorrhages
Contributor Information
Jin Han
Prenatal Diagnositic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
Sihui Zeng
Li Zhen
Xin Yang
Min Pan
Hongsheng Liu
Dongzhi Li
Jie Bai
Yimin Yu
Changping Dai
Can Liao
