PDF(Pubmed)
Abstract：
UNASSIGNED: Reliable airway patency diagnosis in fetal tracheolaryngeal obstruction is crucial to select and plan ex utero intrapartum treatment (EXIT) surgery. We compared the clinical utility of magnetic resonance imaging (MRI) super-resolution reconstruction (SRR) of the trachea, which can mitigate unpredictable fetal motion effects, with standard 2-dimensional (2D) MRI for airway patency diagnosis and assessment of fetal neck mass anatomy.
UNASSIGNED: A single-center case series of 7 consecutive singleton pregnancies with complex upper airway obstruction (2013-2019).
UNASSIGNED: A tertiary fetal medicine unit performing EXIT surgery.
UNASSIGNED: MRI SRR of the trachea was performed involving rigid motion correction of acquired 2D MRI slices combined with robust outlier detection to reconstruct an isotropic high-resolution volume. SRR, 2D MRI, and paired data were blindly assessed by 3 radiologists in 3 experimental rounds.
UNASSIGNED: Airway patency was correctly diagnosed in 4 of 7 cases (57%) with 2D MRI as compared with 2 of 7 cases (29%) with SRR alone or paired 2D MRI and SRR. Radiologists were more confident (P = .026) in airway patency diagnosis when using 2D MRI than SRR. Anatomic clarity was higher with SRR (P = .027) or paired data (P = .041) in comparison with 2D MRI alone. Radiologists detected further anatomic details by using paired images versus 2D MRI alone (P < .001). Cognitive load, as assessed by the NASA Task Load Index, was increased with paired or SRR data in comparison with 2D MRI.
UNASSIGNED: The addition of SRR to 2D MRI does not increase fetal airway patency diagnostic accuracy but does provide improved anatomic information, which may benefit surgical planning of EXIT procedures.
UNASSIGNED: A single-center case series of 7 consecutive singleton pregnancies with complex upper airway obstruction (2013-2019).
UNASSIGNED: A tertiary fetal medicine unit performing EXIT surgery.
UNASSIGNED: MRI SRR of the trachea was performed involving rigid motion correction of acquired 2D MRI slices combined with robust outlier detection to reconstruct an isotropic high-resolution volume. SRR, 2D MRI, and paired data were blindly assessed by 3 radiologists in 3 experimental rounds.
UNASSIGNED: Airway patency was correctly diagnosed in 4 of 7 cases (57%) with 2D MRI as compared with 2 of 7 cases (29%) with SRR alone or paired 2D MRI and SRR. Radiologists were more confident (P = .026) in airway patency diagnosis when using 2D MRI than SRR. Anatomic clarity was higher with SRR (P = .027) or paired data (P = .041) in comparison with 2D MRI alone. Radiologists detected further anatomic details by using paired images versus 2D MRI alone (P < .001). Cognitive load, as assessed by the NASA Task Load Index, was increased with paired or SRR data in comparison with 2D MRI.
UNASSIGNED: The addition of SRR to 2D MRI does not increase fetal airway patency diagnostic accuracy but does provide improved anatomic information, which may benefit surgical planning of EXIT procedures.
摘要：
■胎儿气管喉部梗阻的可靠气道通畅性诊断对于选择和计划子宫外治疗（EXIT）手术至关重要。我们比较了气管磁共振成像（MRI）超分辨率重建（SRR）的临床实用性，可以减轻不可预测的胎动影响，使用标准的二维（2D）MRI诊断气道通畅性和评估胎儿颈部肿块解剖结构。
■7例连续单胎妊娠合并复杂上呼吸道阻塞的单中心病例系列（2013-2019年）。
■执行EXIT手术的三级胎儿医学单位。
■进行气管的MRISRR，涉及对采集的2DMRI切片进行刚性运动校正，并结合鲁棒的异常检测，以重建各向同性的高分辨率体积。SRR,2DMRI,和配对数据由3名放射科医师在3个实验轮中进行盲目评估.
■使用2DMRI正确诊断7例中的4例（57％）气道通畅，而使用单独的或配对的2DMRI和SRR的7例中的2例（29％）正确诊断。放射科医师使用2DMRI比SRR对气道通畅性诊断更有信心（P=0.026）。与单独的2DMRI相比，SRR（P=.027）或配对数据（P=.041）的解剖清晰度更高。放射科医师通过使用配对图像与单独的2DMRI来检测进一步的解剖细节(P<.001)。认知负荷，根据NASA任务负荷指数的评估，与2DMRI相比，配对或SRR数据增加。
■在二维MRI中增加SRR不会提高胎儿气道通畅性诊断的准确性，但确实提供了改善的解剖信息，这可能有利于EXIT程序的手术计划。
■7例连续单胎妊娠合并复杂上呼吸道阻塞的单中心病例系列（2013-2019年）。
■执行EXIT手术的三级胎儿医学单位。
■进行气管的MRISRR，涉及对采集的2DMRI切片进行刚性运动校正，并结合鲁棒的异常检测，以重建各向同性的高分辨率体积。SRR,2DMRI,和配对数据由3名放射科医师在3个实验轮中进行盲目评估.
■使用2DMRI正确诊断7例中的4例（57％）气道通畅，而使用单独的或配对的2DMRI和SRR的7例中的2例（29％）正确诊断。放射科医师使用2DMRI比SRR对气道通畅性诊断更有信心（P=0.026）。与单独的2DMRI相比，SRR（P=.027）或配对数据（P=.041）的解剖清晰度更高。放射科医师通过使用配对图像与单独的2DMRI来检测进一步的解剖细节(P<.001)。认知负荷，根据NASA任务负荷指数的评估，与2DMRI相比，配对或SRR数据增加。
■在二维MRI中增加SRR不会提高胎儿气道通畅性诊断的准确性，但确实提供了改善的解剖信息，这可能有利于EXIT程序的手术计划。
