The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis

Abstract

The aim of this study was to evaluate the role of MR imaging of the fetus to improve sonographic prenatal diagnosis of congenital anomalies. In 40 fetuses (not consecutive cases) with an abnormality diagnosed with ultrasound, additional MR imaging was performed. The basic sequence was a T2-weighted single-shot half Fourier (HASTE) technique. Head, neck, spinal, thoracic, urogenital, and abdominal fetal pathologies were found. This retrospective, observational study compared MR imaging findings with ultrasonographic findings regarding detection, topography, and etiology of the pathology. The MR findings were evaluated as superior, equal to, or inferior compared with US, in consent with the referring gynecologists. The role of these findings in relation to pregnancy management was studied and compared with postnatal follow-up in 30 of 40 babies. Fetal MRI technique was successful in 36 of 39 examinations and provided additional information in 21 of 40 fetuses (one twin pregnancy with two members to evaluate). More precise anatomy and location of fetal pathology (20 of 40 cases) and additional etiologic information (8 of 40 cases) were substantial advantages in cerebrospinal abnormalities [ventriculomegaly, encephalocele, vein of Galen malformation, callosal malformations, meningo(myelo)cele], in retroperitoneal abnormalities (lymphangioma, renal agenesis, multicystic renal dysplasia), and in neck/thoracic pathology [cervical cystic teratoma, congenital hernia diaphragmatica, congenital cystic adenomatoid lung malformation (CCAM)]. This improved parental counseling and pregnancy management in 15 pregnancies. In 3 cases, prenatal MRI findings did not correlate with prenatal ultrasonographic findings or neonatal diagnosis. The MRI provided a more detailed description and insight into fetal anatomy, pathology, and etiology in the vast majority of these selected cases. This improved prenatal parental counseling and postnatal therapeutic planning.

Prenatal and Postnatal Management of Congenital Pulmonary Airway Malformation

“…Today, routine prenatal US screening complemented with magnetic resonance imaging (MRI) has become increasingly valuable in detecting CPAMs [40], with an accuracy of 65-91% [41,42]. Before the advent of prenatal sonography, CPAMs were diagnosed only in symptomatic infants or as an incidental finding.…”

Prenatal Diagnosis of Occipital Dermal Sinus Associated with Hemangioma Using Ultrasound and MRI

“…Hemangiomas of the occipital region are rare, Doppler evaluation allows demonstration of arterial and venous pulsation. Associated brain abnormalities are seen in up to 80% of cases [4][5][6] .…”

Onfalocele gigante. Presentación de un caso en sesión anatomopatológica y consideraciones generales

“…La resonancia magnéti-ca puede jugar un papel importante cuando el diagnóstico por ultrasonido es incierto y para evaluar malformaciones asociadas. 7 Además del diagnóstico se tuvieron que haber buscado anomalías asociadas y determinar un cariotipo. La detección temprana hubiese permitido un asesoramiento adecuado a los padres y planear el manejo obstétrico.…”