Comparison of Magnetic Resonance Imaging and Ultrasonography in the Prenatal Diagnosis of Congenital Thoracic Abnormalities

Abstract

Objectives: To evaluate prenatal MRI in the diagnosis of fetal thoracic abnormalities and to determine whether MRI provides useful information in addition to that of ultrasonography (US). Methods: Ultrafast MR scanning was performed in 7 pregnant women in whom US was suspicious of fetal congenital anomalies of the thorax [3 cases of congenital diaphragmatic hernia (CDH), 3 cases of chylothorax and 1 case of congenital cystic adenomatoid malformation (CCAM) type III]. The presence, position, size and characteristics of the congenital lesions were determined and compared with postnatal diagnoses. Results: The MRI diagnoses were 3 cases of CDH, 2 of chylothorax and one each of esophageal atresia and CCAM type III. The results of MRI were in agreement with those of US in 6 cases and in disagreement in 1 case of esophageal atresia. Final diagnoses were confirmed at surgery or autopsy in all fetuses. Combined use of MR and US imaging enabled a correct diagnosis in 5 cases and led to an error in the diagnosis of 1 fetus with bronchial stenosis, which had been diagnosed as CCAM type III by US and MRI. MRI led to a correct diagnosis in 1 fetus with esophageal atresia, in whom US had been equivocal in the prenatal diagnosis. Conclusion: MRI helped further characterize the fetal thoracic lesions and confirmed or changed the prenatal diagnosis based on US. MRI seems to be powerful in the prenatal diagnosis of thoracic lesions that are atypical or complicated by multiple abnormalities.

The use of combined ultrasound and magnetic resonance imaging in the detection of fetal anomalies

“…From the published literature, it would appear that MRI may provide additional diagnostic information to that given by ultrasound in 25% to 55% of cases, which *Correspondence to: Ramesha Papanna, Texas Children's Fetal Center, MC2-2521, 6621 Fannin Street, Houston, TX 77030, USA. E-mail: rpapanna@gmail.com in turn would impact parental counseling and/or management of affected pregnancies (Levine et al, 1997;Wagenvoort et al, 2000;Breysem et al, 2003;Matsuoka et al, 2003;Blaicher et al, 2004;Frates et al, 2004;Whitby et al, 2004;Salomon et al, 2006;Wang et al, 2006). MRI seems most consistently useful in characterizing fetal anomalies involving the central nervous system (Levine et al, 1997;Wagenvoort et al, 2000;Breysem et al, 2003;Wang et al, 2006).…”

Fetal magnetic resonance imaging and ultrasound

“…Confirmation of fetal lung hypoplasia should be carried out when there is an oligohydramnios in the second trimester, congenital diaphragmatic hernia (CDH), distortion of thoracic cage in skeletal dysplasia, or tumor mass in the thorax of the fetus [31]. Diagnosis of congenital high airway obstruction (CHAOS) may not be conclusive on prenatal ultrasound examination.…”

EXIT Procedure: Technique and Indications with Prenatal Imaging Parameters for Assessment of Airway Patency

“…Discrete cysts may be identified if they are large (38). Some masses can be isointense relative to the lung, since the fluid content of the lung and the mass may be similar (39).…”