Prenatal MRI diagnosis of congenital cystic adenomatoid malformation
1. Department of Radiology, Guangdong Women and Children Hospital, Guangzhou 510010, China;
2. Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
Abstract：Objective: To assess the value of MRI in the diagnosis of congenital cystic adenomatoid malformation(CCAM). Methods: Fifty-three fetuses suspected of CCAM by MRI were collected from March 2013 to December 2015. All the fetuses underwent postnatal low dose enhanced CT examination and surgery. The MRI features of fetal CCAM were retrospectively analyzed, with the result of pathology as the golden standard. Among them, 8 fetuses underwent MRI twice, and the change of mass size was evaluated. Results: In the 53 cases, 52 cases of CCAM were confirmed by pathology, and 1 case was congenital lobar emphysema(CLE). In the 52 cases of CCAM, 28 cases were macrocystic type, showing clear border, multiple cysts with long T2 signal in the pulmonary lobe, septa of short T2 signal, and the diameter of the cysts was larger than 5 mm; 24 cases were microcystic type, showing clear border, homogeneity or microcysts with long T2 singal in the pulmonary lobe, and the diameter of cysts was smaller than 5 mm. Eight CCAM cases underwent two MRI examinations, 5 cases of which had no significant change in size and signal of the lesion, but 3 cases decreased in both size and signal. In the 53 fetuses, hearts shifted to the right in 17 cases, and to the left in 23 cases. Fifty-two fetuses were not associated with fetal hydrops, and 3 fetuses had polyhydramnios. Conclusion: MRI has great diagnostic value for CCAM. It can not only correctly demonstrate the location, type and change of the lesion, but also observe the degree of compression of surrounding organs. It can provide accurate information for the clinical prognosis of the fetus.
