POSTAVLJANJE DIJAGNOZE OTVORENOG DEFEKTA NEURALNE CEVI UZ POMOĆ MAGNETNE REZONANCE
Sažetak
Defekti neuralne cevi predstavljaju grupu poremećaja koja obuhvata spinu bifidu, anencefaliju, interspinalni lipom, urođeni dermalni sinus, jednostavnu vezanu vrpcu i druge bolesti koje mogu izazvati neurološke probleme kao što su motorni i/ili senzorni poremećaji i urinarna i/ili fekalna inkontinencija. Ovi poremećaji obično se mogu dijagnostikovati kombinovanom interpretacijom alfa fetoproteina i ultrazvučnog snimanja. Međutim, ponekad je kvalitet slike sa ultrazvuka loš i zahteva upotrebu tehnike snimanja veće rezolucije – magnetnu rezonancu (engl. magnetic resonance imaging – MRI).
Žena u 18. nedelji trudnoće imala je zakazan rutinski prenatalni pregled. Nakon pregleda je uočen blag, ali sumnjiv znak limuna na lobanji fetusa. Sagitalni pogled na kičmu fetusa dao je rezultate u okrivu normalnih vrednosti, ali se transverzalni presek kičme nije mogao sagledati na adekvatan način. Kvalitet kompletnog ultrazvučnog snimanja bio je lošiji zbog fetalnih i majčinskih faktora. Stoga, doneta je odluka da se obavi MRI fetusa, kojim je potvrđena otvorena spina bifida.
Budući da je MRI bolji alat od ultrazvuka, u svim slučajevima u kojima nije moguće konačno dijagnostikovati defekt neuralne cevi ultrazvukom (bez obzira na razlog) akušer treba da se odluči za MRI da bi se to stanje potvrdilo.
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