Bi-parametric magnetic resonance imaging applied to obstetrics

Abstract

Foetal magnetic resonance imaging (MRI) plays an increasingly important role in the diagnosis of foetal abnormalities. Over the years, we have successfully applied bi-parametric MRI (bp-MRI) to the following obstetric conditions: (1) neurologic vascular diseases; (2) assessment of lung parenchyma maturation; (3) renal pathologies, such as polycystic kidney, suspected renal infarction, unilateral or bilateral renal agenesis; (4) placental pathologies, as twin-twin transfusion syndrome or placenta accreta; (5) benignant and malignant congenital tumours or cysts of the liver, such as haemangioendothelioma, hepatoblastoma or metastatic neuroblastoma, of the kidney (e.g. mesoblastic nephroma) and of the retroperitoneum, such as teratoma. The information derived from bp-MRI, and concerned with water motions in different tissues, improved the morphologic details provided by conventional foetal MRI. It has the potential to increase the value of MRI in the assessment of a wide range of foetal pathologies, particularly in renal diseases, allowing an adequate management decision and therapy.

Fetal biparametric MR imaging in the diagnosis of congenital mesoblastic nephroma

“…[2] Magnetic resonance (MR) imaging is a complementary technique that contributes to the accurate identification of fetal anomalies, especially in the identification of urogenital and encephalic malformations. [3] In this brief report, we emphasize the advantages of biparametric MR imaging, including T2-weighted images (T2WI) and diffusionweighted images (DWI) in the diagnosis of CMN.…”

“…[2,3,[9][10][11][12] Its systematic use could help to identify in many cases the nature of the fetal problem and to predict the risk of stillbirth [10,11] , as a complementary to other sophisticated research methods. [13][14][15][16][17] This would be very important in order to try to prevent stillbirth itself, an event that too often remains unexplained even today.…”

The Real-Time Elastography (RTE) Increases the Diagnostic Accuracy of Testicular Focal Lesions

“…MRI has been advocated as an adjunct to unenhanced US and CE-US examination and it can be used as a problemsolving tool in cases of equivocal findings or uncertainty, as also occurs in other diagnostic fields [20,21], decreasing the number of unnecessary surgical procedures. MRI can potentially characterize benign and malignant testicular lesions and can suggest a specific diagnostic hypothesis (e.g., Leydig cell tumor and seminoma) when specific imaging features are present [11].…”

Neuropathological protocol for the study of unexplained stillbirth

“…The immunostaining for the detection of apoptosis (TUNEL method) and glial fibrillary acid protein (GFAP) are also recommended to obtain further information about a possible abnormal increase of neuronal death, over the physiological levels, and the presence of reactive gliosis, a well-known marker of neurodegenerative processes [19,21].…”

“…Therefore, the detection of the pathogenetic mechanism leading to stillbirth is very important, and not just to give an answer to parents, but above all to introduce preventive measures in order to lower prenatal mortality [1]. The value of a post-mortem examination, as the gold standard investigation following stillbirth, is well documented [18,19,[23][24][25][26]29]. In particular, the impor-tance of an adequate fetal examination has been emphasized in a recent policy on the subject by the American Board of Pathology [3].…”