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Bisht RU, Belthur MV, Singleton IM, Goncalves LF. Accuracy of Multimodality Fetal Imaging (US, MRI, and CT) for Congenital Musculoskeletal Anomalies. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1015. [PMID: 37371247 DOI: 10.3390/children10061015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/14/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Ultrasonography (US) is the first-line diagnostic tool used to assess fetal musculoskeletal (MSK) anomalies. Associated anomalies in other organ systems may benefit from evaluation via Magnetic Resonance Imaging (MRI). In this study, we compared the diagnostic accuracy of US and MRI to diagnose fetal MSK (primary objective) and non-MSK anomalies (secondary objective). We describe additional findings by low-dose computerized tomography (CT) in two cases incompletely characterized via US and MRI. MATERIALS AND METHODS This was an IRB-approved retrospective study of consecutive patients with suspected fetal MSK anomalies examined between December 2015 and June 2020. We compared individual MSK and non-MSK anomalies identified via US, MRI, and CT with postnatal outcomes. Sensitivity and specificity for US and MRI were calculated and compared. RESULTS A total of 31 patients with 112 MSK and 43 non-MSK anomalies were included. The sensitivity of MRI and US for MSK anomalies was not significantly different (76.6% vs. 61.3%, p = 0.3). Low-dose CT identified eight additional skeletal anomalies. MRI diagnosed a higher number of non-MSK anomalies compared to US (81.4% vs. 37.2%, p < 0.05). CONCLUSIONS Fetal MRI and US have comparable sensitivity for MSK anomalies. In selected cases, low-dose CT may provide additional information. Fetal MRI detected a larger number of non-MSK anomalies in other organ systems compared to US. Multimodality imaging combining all the information provided by MRI, US, and CT, if necessary, ultimately achieved a sensitivity of 89.2% (95% CI: 83.4% to 95.0%) for the diagnosis of musculoskeletal anomalies and 81.4% for additional anomalies in other organs and systems.
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Affiliation(s)
- Roy U Bisht
- University of Arizona College of Medicine-Phoenix, 475 N. 5th St., Phoenix, AZ 85004, USA
| | - Mohan V Belthur
- Department of Child Health & Orthopedics, University of Arizona College of Medicine-Phoenix, 1919 E. Thomas Rd., Phoenix, AZ 85004, USA
- Department of Surgery, Medical School, Creighton University, Omaha, NE 68178, USA
| | - Ian M Singleton
- University of Arizona College of Medicine-Phoenix, 475 N. 5th St., Phoenix, AZ 85004, USA
| | - Luis F Goncalves
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ 85016, USA
- Child Health and Radiology, University of Arizona College of Medicine-Phoenix, 475 N. 5th St., Phoenix, AZ 85004, USA
- Radiology, Mayo Clinic, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA
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2
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Colleran GC, Kyncl M, Garel C, Cassart M. Fetal magnetic resonance imaging at 3 Tesla - the European experience. Pediatr Radiol 2022; 52:959-970. [PMID: 35147713 DOI: 10.1007/s00247-021-05267-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/22/2021] [Accepted: 12/11/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The Fetal Imaging Taskforce was established in 2018 by the European Society of Paediatric Radiology. The first survey on European practice of fetal imaging published in 2020 revealed that 30% of fetal magnetic resonance imaging (MRI) is performed at 3 tesla (T). The purpose of this second survey was to identify the impact of 3-T fetal MRI with an emphasis on image quality, diagnostic yield, and technical challenges and artifacts at higher field strengths. OBJECTIVE To describe the prenatal imaging practice at 3-T MRI units in various centres in Europe and to prepare recommendations on behalf of the Fetal Imaging Taskforce. MATERIALS AND METHODS A survey was sent to all members performing 3-T fetal MRI. Questions included practitioner experience, magnet brand, protocols, counselling, artifacts and benefits of imaging at higher field strengths. RESULTS Twenty-seven centres replied and reported improved spatial resolution and improved signal-to-noise ratio when performing fetal MRI at 3 T. Shading and banding artifacts and susceptibility to motion artifacts were common problems identified by practitioners at the higher field strength. For all neurological indications, practitioners reported a benefit of imaging at 3 T, most marked for posterior fossa evaluation and parenchymal lesions. CONCLUSION The use of 3-T magnets in fetal MRI has improved the availability and quality of advanced imaging sequences and allowed for better anatomical evaluation. There remain significant challenges to minimize the impact of artifacts on image quality. This paper includes guidelines for clinical practice and imaging at 3 T.
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Affiliation(s)
- Gabrielle C Colleran
- Department of Radiology, National Maternity Hospital, Holles Street, Dublin 2, Ireland. .,Department of Radiology, Children's Health Ireland, Dublin, Ireland. .,Discipline of Paediatrics, Trinity College Dublin and Women's and Children's Health, UCD School of Medicine, University College Dublin, Dublin, Ireland.
| | - Martin Kyncl
- Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Catherine Garel
- Department of Radiology, Hôpital d'Enfants Armand-Trousseau, AP-HP, Paris, France
| | - Marie Cassart
- Department of Radiology and Fetal Medicine, Iris South Hospitals and CHU St Pierre, Brussels, Belgium
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3
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Magnetic resonance imaging of the fetal musculoskeletal system. Pediatr Radiol 2020; 50:2009-2027. [PMID: 33252766 DOI: 10.1007/s00247-020-04769-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/29/2020] [Accepted: 07/01/2020] [Indexed: 12/21/2022]
Abstract
Diagnosing musculoskeletal pathology requires understanding of the normal embryological development. Intrinsic errors of skeletal development are individually rare but are of paramount clinical importance because anomalies can greatly impact patients' lives. An accurate assessment of the fetal musculoskeletal system must be performed to provide optimal genetic counseling as well as to drive therapeutic management. This manuscript reviews the embryology of skeletal development and the appearance of the maturing musculoskeletal system on fetal MRI. In addition, it presents a comprehensive review of musculoskeletal fetal pathology along with postnatal imaging.
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Coblentz AC, Teixeira SR, Mirsky DM, Johnson AM, Feygin T, Victoria T. How to read a fetal magnetic resonance image 101. Pediatr Radiol 2020; 50:1810-1829. [PMID: 33252751 DOI: 10.1007/s00247-020-04768-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/22/2020] [Accepted: 07/01/2020] [Indexed: 12/18/2022]
Abstract
Accurate antenatal diagnosis is essential for planning appropriate pregnancy management and improving perinatal outcomes. The provision of information vital for prognostication is a crucial component of prenatal imaging, and this can be enhanced by the use of fetal MRI. Image acquisition, interpretation and reporting of a fetal MR study can be daunting to the individual who has encountered few or none of these examinations. This article provides the radiology trainee with a general approach to interpreting a fetal MRI. The authors review the added value of prenatal MRI in the overall assessment of fetal wellbeing, discuss MRI protocols and techniques, and review the normal appearance of maternal and fetal anatomy. The paper concludes with a sample template for structured reporting, to serve as a checklist and guideline for reporting radiologists.
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Affiliation(s)
- Ailish C Coblentz
- Radiology Department, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 10104, USA
| | - Sara R Teixeira
- Radiology Department, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 10104, USA
| | - David M Mirsky
- Neuroradiology Department, Children's Hospital of Colorado, Aurora, CO, USA
| | - Ann M Johnson
- Radiology Department, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 10104, USA
| | - Tamara Feygin
- Radiology Department, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 10104, USA
| | - Teresa Victoria
- Radiology Department, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 10104, USA.
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5
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Filges I, Tercanli S, Hall JG. Fetal arthrogryposis: Challenges and perspectives for prenatal detection and management. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2019; 181:327-336. [PMID: 31318155 DOI: 10.1002/ajmg.c.31723] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/23/2019] [Accepted: 06/27/2019] [Indexed: 12/28/2022]
Abstract
Antenatal identification of fetuses with multiple congenital contractures or arthrogryposis multiplex congenita (AMC) may be challenging. The first clinical sign is often reduced fetal movement and/or contractures, as seen on prenatal ultrasounds. This can be apparent at any point, from early to late pregnancy, may range from mild to severe involvement, with or without associated other structural anomalies. Possible etiologies and their prognosis need to be interpreted with respect to developmental timing. The etiology of AMC is highly heterogeneous and making the specific diagnosis will guide prognosis, counseling and prenatal and perinatal management. Current ultrasound practice identifies only approximately 25% of individuals with arthrogryposis prenatally before 24 weeks of pregnancy in a general obstetrics care population. There are currently no studies and guidelines that address the question of when and how to assess for fetal contractures and movements during pregnancy. The failure to identify fetuses with arthrogryposis before 24 weeks of pregnancy means that physicians and families are denied reproductive options and interventions that may improve outcome. We review current practice and recommend adjusting the current prenatal imaging and genetic diagnostic strategies to achieve early prenatal detection and etiologic diagnosis. We suggest exploring options for in utero therapy to increase fetal movement for ongoing pregnancies.
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Affiliation(s)
- Isabel Filges
- Medical Genetics, Institute of Medical Genetics and Pathology, University Hospital and University of Basel, Basel, Switzerland
| | - Sevgi Tercanli
- Center for Prenatal Ultrasound, Basel and University of Basel, Basel, Switzerland
| | - Judith G Hall
- Department of Medical Genetics and Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada
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Miao M, Lin X, Zhang Z, Zhao H. Normal development of the fetal spinal canal and spinal cord at T12 on 3.0-T MRI. Acta Radiol 2019; 60:623-627. [PMID: 30142995 DOI: 10.1177/0284185118791197] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The studies that described the dimensions of the normal fetal thoracic spinal canal and spinal cord on magnetic resonance imaging (MRI) are scarce. PURPOSE To determine the normal appearance of the fetal spinal canal and spinal cord at T12 across different gestational ages using 3.0-T MRI. MATERIAL AND METHODS The spines of 43 normal human fetuses, aged 15-40 weeks, were scanned by 3.0-T MRI. All specimens were scanned using a GE 3.0-T MRI scanner. Imaging of the T12 vertebrae was performed in the coronal, sagittal, and axial planes. The anterior-posterior (AP) diameter, width, and cross-sectional area of the spinal canal and spinal cord at T12 were measured. The influence of gestational age on these parameters was investigated with a scatter plot and linear regression analysis using Pearson correlation coefficient. RESULTS The normal morphology of the fetal vertebra at T12 can be clearly showed by MRI; the spinal canal appeared circular, while the spinal cord was ellipsoid. Linear regression analysis showed a significant positive correlation between the AP diameter, width, and cross-sectional area of the spinal canal at T12 and gestational age. CONCLUSION Postmortem MRI is a reliable method for understanding the growth dynamics of the spinal canal and spinal cord at T12. Findings from this study would benefit the prenatal diagnosis of congenital malformations by MRI.
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Affiliation(s)
- Mingming Miao
- Shandong University School of Medicine, The Fifth People’s Hospital of Jinan, Shandong, PR China
| | - Xiangtao Lin
- Shandong University School of Medicine, Shandong Medical Imaging Research Institute, Shandong, PR China
| | - Zhonghe Zhang
- Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, PR China
| | - Hui Zhao
- Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, PR China
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Werner H, Nogueira R, Lobo Lopes FPP. MR Imaging of Fetal Musculoskeletal Disorders. Magn Reson Imaging Clin N Am 2019; 26:631-644. [PMID: 30316472 DOI: 10.1016/j.mric.2018.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This article outlines the main findings in prenatal musculoskeletal disorders. Three main technologies are generally used to obtain images within the uterus during pregnancy: ultrasound (US), MR imaging, and computed tomography (CT). Currently, the primary imaging method used for fetal assessment during pregnancy is US because it is patient friendly, useful, cost-effective, and (considered) safe. MR imaging is generally performed when US yields equivocal results because it offers additional information about fetal abnormalities and conditions in situations in which US is unable to provide high-quality images.
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Affiliation(s)
- Heron Werner
- Radiology Department, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, sala 301B, Centro Médico BarraShopping, CDPI, Barra da Tijuca, Rio de Janeiro, RJ CEP: 22640-102, Brazil; Radiology Department, Alta Excelência Diagnóstica/DASA, Avenida das Américas, 4666, sala 301B, Centro Médico BarraShopping, CDPI, Barra da Tijuca, Rio de Janeiro, RJ CEP: 22640-102, Brazil.
| | - Renata Nogueira
- Radiology Department, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, sala 301B, Centro Médico BarraShopping, CDPI, Barra da Tijuca, Rio de Janeiro, RJ CEP: 22640-102, Brazil; Radiology Department, Alta Excelência Diagnóstica/DASA, Avenida das Américas, 4666, sala 301B, Centro Médico BarraShopping, CDPI, Barra da Tijuca, Rio de Janeiro, RJ CEP: 22640-102, Brazil
| | - Flávia Paiva Proença Lobo Lopes
- Radiology Department, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, sala 301B, Centro Médico BarraShopping, CDPI, Barra da Tijuca, Rio de Janeiro, RJ CEP: 22640-102, Brazil; Radiology Department, Alta Excelência Diagnóstica/DASA, Avenida das Américas, 4666, sala 301B, Centro Médico BarraShopping, CDPI, Barra da Tijuca, Rio de Janeiro, RJ CEP: 22640-102, Brazil; Radiology Department, Federal University of Rio de Janeiro (UFRJ), Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ CEP: 21941-913, Brazil
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8
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Offiah AC, Vockley J, Munns CF, Murotsuki J. Differential diagnosis of perinatal hypophosphatasia: radiologic perspectives. Pediatr Radiol 2019; 49:3-22. [PMID: 30284005 PMCID: PMC6313373 DOI: 10.1007/s00247-018-4239-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 06/25/2018] [Accepted: 08/14/2018] [Indexed: 01/13/2023]
Abstract
Perinatal hypophosphatasia (HPP) is a rare, potentially life-threatening, inherited, systemic metabolic bone disease that can be difficult to recognize in utero and postnatally. Diagnosis is challenging because of the large number of skeletal dysplasias with overlapping clinical features. This review focuses on the role of fetal and neonatal imaging modalities in the differential diagnosis of perinatal HPP from other skeletal dysplasias (e.g., osteogenesis imperfecta, campomelic dysplasia, achondrogenesis subtypes, hypochondrogenesis, cleidocranial dysplasia). Perinatal HPP is associated with a broad spectrum of imaging findings that are characteristic of but do not occur in all cases of HPP and are not unique to HPP, such as shortening, bowing and angulation of the long bones, and slender, poorly ossified ribs and metaphyseal lucencies. Conversely, absent ossification of whole bones is characteristic of severe lethal HPP and is associated with very few other conditions. Certain features may help distinguish HPP from other skeletal dysplasias, such as sites of angulation of long bones, patterns of hypomineralization, and metaphyseal characteristics. In utero recognition of HPP allows for the assembly and preparation of a multidisciplinary care team before delivery and provides additional time to devise treatment strategies.
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Affiliation(s)
- Amaka C Offiah
- Academic Unit of Child Health, Sheffield Children's NHS Foundation Trust, University of Sheffield, Western Bank, Sheffield, S10 2TH, UK.
| | - Jerry Vockley
- School of Medicine and Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Craig F Munns
- The Children's Hospital at Westmead, Westmead, NSW, Australia
- Sydney Medical School, The University of Sydney, University of Sydney NSW, Sydney, Australia
| | - Jun Murotsuki
- Aoba Ward, Miyagi Children's Hospital, Sendai, Miyagi Prefecture, Japan
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9
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Nogueira RDA, Werner Júnior H, Daltro P, Lima GM, Barbosa AD, Araujo Júnior E. The role of a novel magnetic resonance imaging sequence in the evaluation of the fetal skeleton: a pilot study. Radiol Bras 2018; 51:303-307. [PMID: 30369657 PMCID: PMC6198829 DOI: 10.1590/0100-3984.2017.0100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective We aimed to study the role of magnetic resonance imaging (MRI), including a
novel MRI sequence-the modified volumetric interpolated breath-hold
examination (VIBE)-in the characterization of the fetal skeleton. This novel
sequence was useful for reconstructing three-dimensional images of the
skeleton. Materials and Methods We enrolled 22 pregnant women whose fetuses had shown congenital
abnormalities on ultrasound examinations. The women underwent prenatal fetal
MRI in a 1.5-T scanner with a T2-weighted modified VIBE sequence.
Three-dimensional reconstructions of the fetal skeleton were performed
manually on the instrument itself or via an interactive pen-tablet
workstation. Results Three-dimensional reconstructions of the fetal skeleton were performed after
the acquisition of modified VIBE MRI sequences, and it was possible to
characterize the fetal skeleton in all MRI examinations. Conclusion A detailed evaluation of the three-dimensional reconstructions of fetal
skeleton performed after acquisition of a modified VIBE MRI sequence allowed
a full characterization of the skeleton. However, improvements to the
proposed sequence should be addressed in future studies.
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Affiliation(s)
| | | | - Pedro Daltro
- Clínica de Diagnóstico Por Imagem (CDPI), Rio de Janeiro, RJ, Brazil
| | - Glaucia Macedo Lima
- Department of Maternal-Infant Care, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Adauto Dutra Barbosa
- Department of Maternal-Infant Care, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
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10
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Jian N, Tian MM, Xiao LX, Zhao H, Shi Y, Li G, Zhang S, Lin XT. Normal development of sacrococcygeal centrum ossification centers in the fetal spine: a postmortem magnetic resonance imaging study. Neuroradiology 2018; 60:821-833. [PMID: 29974142 DOI: 10.1007/s00234-018-2050-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/25/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the temporal pattern of the appearance of the S1-Co1 centrum ossification centers (COCs) and provide reference data for the S1-S5 COCs and sacral length at various gestational ages (GAs). METHODS Postmortem magnetic resonance imaging (MRI) was performed on 71 fetuses (GA, 17-42 weeks) using the 3D dual-echo steady-state with water excitation T2 sequence in the sagittal plane. To confirm the reliability of this sequence, the MRI data were compared with the CT and histologic data obtained from two fetuses (GAs, 21 and 30 weeks). The presence or absence of each sacrococcygeal COC was recorded. Sacral length and S1-S5 COC height, sagittal diameter, transverse diameter, cross-sectional area, and volume were measured. RESULTS All fetuses showed S1-S3 COCs by 17 weeks, S4 COCs by 19 weeks, and S5 COCs by 28 weeks. The S4, S5, and Co-1 COCs were visualized in 70 (98.59%), 51 (71.83%), and 21 (29.58%) fetuses, respectively. Sacral length, height, sagittal, and transverse diameters increased linearly, while cross-sectional area and volume increased exponentially with advancing GA. Mean growth rates of the sagittal and transverse diameters, cross-sectional area, and volume, but not of height, significantly differed among the S1-S5 vertebrae. CONCLUSION We have presented the timing of appearance of individual sacrococcygeal COCs and the age-specific, normative MRI reference values for sacral length and the morphometric parameters of the sacral COCs, which are of clinical importance in the diagnosis of congenital sacral abnormalities and skeletal dysplasia.
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Affiliation(s)
- Nan Jian
- Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012, Shandong, China.,CT Department, Heze Municipal Hospital, No. 2888 West Caozhou Road, Heze, 274031, Shandong, China
| | - Mi-Mi Tian
- Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012, Shandong, China
| | - Lian-Xiang Xiao
- Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012, Shandong, China
| | - Hui Zhao
- Department of Imaging, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Yan Shi
- Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012, Shandong, China
| | - Guan Li
- College of Radiology, Taishan Medical University, NO.619 Great Wall Road, Taian, 271016, Shandong, China
| | - Shuai Zhang
- Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012, Shandong, China
| | - Xiang-Tao Lin
- Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012, Shandong, China.
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Weisstanner C, Gruber GM, Brugger PC, Mitter C, Diogo MC, Kasprian G, Prayer D. Fetal MRI at 3T-ready for routine use? Br J Radiol 2017; 90:20160362. [PMID: 27768394 PMCID: PMC5605013 DOI: 10.1259/bjr.20160362] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Fetal MR now plays an important role in the clinical work-up of pregnant females. It is performed mainly at 1.5 T. However, the desire to obtain a more precise fetal depiction or the fact that some institutions have access only to a 3.0 T scanner has resulted in a growing interest in performing fetal MR at 3.0 T. The aim of this article was to provide a reference for the use of 3.0 T MRI as a prenatal diagnostic method.
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Affiliation(s)
- Christian Weisstanner
- 1 Division of Neuro- and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
- 2 Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Gerlinde M Gruber
- 3 Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Peter C Brugger
- 3 Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Christan Mitter
- 1 Division of Neuro- and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Mariana C Diogo
- 4 Neuroradiology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Gregor Kasprian
- 1 Division of Neuro- and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Daniela Prayer
- 1 Division of Neuro- and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
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12
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Said AH, El-Kattan E, Abdel-Hakeem AK, Saleem S. In utero MRI diagnosis of fetal malformations in oligohydramnios pregnancies. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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13
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Alrabai HM, Farr A, Bettelheim D, Weber M, Farr S. Prenatal diagnosis of congenital upper limb differences: a current concept review. J Matern Fetal Neonatal Med 2016; 30:2557-2563. [PMID: 27809626 DOI: 10.1080/14767058.2016.1256989] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Congenital upper limb differences are frequently associated with complex syndromes. Ultrasonography is considered as the first-line diagnostic modality, and fetal MRI can be useful to further evaluate ill-defined areas. Genetic and non-invasive prenatal testing help to identify the underlying genetic disorder. The diagnostic assessment is a multidisciplinary task that should involve early prenatal consultations with specialists involved in case management and treatment planning. Obstetricians, geneticists, radiologists, psychologists and dedicated surgeons are needed to provide good parental education, prenatal and postnatal care, and successful outcomes. The purpose of this review is to provide an overview of the clinicopathologic background, current diagnostic and imaging procedures in affected fetuses.
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Affiliation(s)
- Hamza M Alrabai
- a Department of Orthopaedics , King Saud University , Riyadh , Saudi Arabia
| | - Alex Farr
- b Department of Obstetrics and Gynaecology , Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna , Vienna , Austria , and
| | - Dieter Bettelheim
- b Department of Obstetrics and Gynaecology , Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna , Vienna , Austria , and
| | - Myriam Weber
- b Department of Obstetrics and Gynaecology , Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna , Vienna , Austria , and
| | - Sebastian Farr
- c Department of Pediatric Orthopaedics and Adult Foot and Ankle Surgery , Orthopaedic Hospital Speising , Vienna , Austria
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14
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Lyons K, Cassady C, Mehollin-Ray A, Krishnamurthy R. Current Role of Fetal Magnetic Resonance Imaging in Body Anomalies. Semin Ultrasound CT MR 2015; 36:310-23. [PMID: 26296482 DOI: 10.1053/j.sult.2015.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Fetal MR body applications have become more common in recent years as both in utero therapies, including fetoscopic surgery, and improvements in perinatal care have increased the demand for precise antenatal anatomic detail. This article discusses the variety of fast imaging sequences available to the fetal imager and describes their applications to both common and unusual congenital pathologies, including of the neck, chest, abdomen/pelvis and musculoskeletal systems.
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Affiliation(s)
- Karen Lyons
- EB Singleton Department of Diagnostic Radiology, Texas Children׳s Hospital, Baylor College of Medicine, Houston, TX
| | - Christopher Cassady
- EB Singleton Department of Diagnostic Radiology, Texas Children׳s Hospital, Baylor College of Medicine, Houston, TX.
| | - Amy Mehollin-Ray
- EB Singleton Department of Diagnostic Radiology, Texas Children׳s Hospital, Baylor College of Medicine, Houston, TX
| | - Rajesh Krishnamurthy
- EB Singleton Department of Diagnostic Radiology, Texas Children׳s Hospital, Baylor College of Medicine, Houston, TX
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15
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Loomba R, Shah PH, Anderson RH. Fetal Magnetic Resonance Imaging of Malformations Associated with Heterotaxy. Cureus 2015; 7:e269. [PMID: 26180693 PMCID: PMC4494530 DOI: 10.7759/cureus.269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2015] [Indexed: 02/07/2023] Open
Abstract
Magnetic resonance imaging (MRI) is increasingly used as an investigation during fetal life, particularly for assessment of intracranial masses, congenital diaphragmatic hernia, myelomeningocele, and abdominal masses. As the number of scans increases, so is the variety of congenital malformations being recognized. It is axiomatic that interpretation of the findings is enhanced when attention is paid to the likely findings in the setting of known syndromes, this information then dictating the need for additional acquisition of images. One such syndrome is so-called "visceral heterotaxy", in which there is typically an isomeric, rather than a lateralized, arrangement of the thoracic and abdominal organs. Typically associated with complex congenital cardiac malformations, heterotaxy can also involve the central nervous system, and produce pulmonary, gastrointestinal, immunologic, and genitourinary malformations. In this review, we discuss how these findings can be demonstrated using fetal MRI.
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Affiliation(s)
- Rohit Loomba
- Cardiology Dept., Children's Hospital of Wisconsin
| | - Parinda H Shah
- Department of Radiology, Advocate Illinois Masonic Medical Center
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16
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Asenbaum U, Brugger PC, Woitek R, Furtner J, Prayer D. [Indications and technique of fetal magnetic resonance imaging]. Radiologe 2013; 53:109-15. [PMID: 23340683 DOI: 10.1007/s00117-012-2397-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CLINICAL/METHODICAL ISSUE Evaluation and confirmation of fetal pathologies previously suspected or diagnosed with ultrasound. STANDARD RADIOLOGICAL METHODS Ultrasound and magnetic resonance imaging (MRI). METHODICAL INNOVATIONS Technique for prenatal fetal examination. PERFORMANCE Fetal MRI is an established supplementary technique to prenatal ultrasound. ACHIEVEMENTS Fetal MRI should only be used as an additional method in prenatal diagnostics and not for routine screening. PRACTICAL RECOMMENDATIONS Fetal MRI should only be performed in perinatal medicine centers after a previous level III ultrasound examination.
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Affiliation(s)
- U Asenbaum
- Abteilung für Neuroradiologie und Muskuloskelettale Radiologie, Universitätsklinik für Radiodiagnostik, Medizinische Universität Wien, Österreich.
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17
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Macé G, Sonigo P, Cormier-Daire V, Aubry MC, Martinovic J, Elie C, Gonzales M, Carbonne B, Dumez Y, Le Merrer M, Brunelle F, Benachi A. Three-dimensional helical computed tomography in prenatal diagnosis of fetal skeletal dysplasia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2013; 42:161-168. [PMID: 22945478 DOI: 10.1002/uog.12298] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/16/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES (1) To study the use and diagnostic value, as a complement to ultrasound, of helical computed tomography (helical CT) to differentiate normal fetuses from cases of skeletal dysplasia; (2) to define the most relevant indications for helical CT; and (3) to evaluate its diagnostic performance with respect to radiological criteria considered discriminatory. METHODS This was a retrospective study from 2005 to 2008 in 67 pregnant women who underwent helical CT after 26 weeks of gestation for suspected fetal skeletal dysplasia due to fetal shortened long bones on ultrasound (≤ 10(th) percentile), either alone or associated with other bone abnormalities. The results were compared with pediatric examinations in 41 cases and with fetal autopsy findings after elective termination of pregnancy in the others. RESULTS Helical CT had a sensitivity of 82%, specificity of 91% and positive and negative predictive values of 90% and 83%, respectively, for diagnosis of fetal skeletal dysplasia. An etiological diagnosis that had not been suspected at ultrasound was specified in 15% of cases and diagnoses suspected at ultrasound were confirmed in 24% and discounted in 43% of cases. The prevalence of skeletal dysplasia was increased in cases of micromelia < 3(rd) percentile or if there was a combination of bone signs. Helical CT showed 69% sensitivity in identifying individual predefined pathological bone signs which were confirmed on fetal autopsy findings. CONCLUSION Helical CT is a key examination, in combination with ultrasound, in the diagnosis of fetal skeletal dysplasia from 26 weeks of gestation. It should be reserved for cases with severe micromelia below the 3(rd) percentile and for those with micromelia ≤ 10(th) percentile associated with another bone sign. A checklist of discriminatory signs is proposed.
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Affiliation(s)
- G Macé
- Obstetrics and Gynecology Department, CHU Bocage, University of Burgundy, Dijon, France.
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18
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Filges I, Hall JG. Failure to identify antenatal multiple congenital contractures and fetal akinesia - proposal of guidelines to improve diagnosis. Prenat Diagn 2013; 33:61-74. [DOI: 10.1002/pd.4011] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Isabel Filges
- Department of Medical Genetics, BC Children's and Women's Hospital, Child and Family Research Institute; University of British Columbia; Vancouver Canada
- Division of Medical Genetics, University Children's Hospital and Department of Biomedicine; University of Basel; Basel Switzerland
| | - Judith G. Hall
- Department of Medical Genetics, BC Children's and Women's Hospital, Child and Family Research Institute; University of British Columbia; Vancouver Canada
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