Nagaraj UD, Calvo-Garcia MA, Merrow AC, Zhang B, Kline-Fath BM. Decreased rectal meconium signal on MRI in fetuses with open spinal dysraphism.
Prenat Diagn 2018;
38:870-875. [PMID:
30094854 DOI:
10.1002/pd.5344]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/17/2018] [Accepted: 08/04/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE
To evaluate rectal meconium signal in fetuses with open spinal dysraphism and correlate findings with postnatal exam.
METHODS
This is a single-institution Institutional Review Board-approved Health Insurance Portability and Accountability Act (HIPAA) compliant retrospective analysis of fetal MRIs of open spinal dysraphism from 2004 to 2016. Fetuses with diagnostic T1-weighted images and postnatal follow-up at our institution were included.
RESULTS
A total of 115 fetuses (average gestational age 23.9 ± 3.6 weeks) met inclusion criteria. Of these, 80% (92/115) had T1 hyperintense rectal meconium signal. Average height of the meconium column, measured from the base of the bladder to its most inferior extent, was 9.2 ± 4.3 mm in fetuses ≥20-week gestational age and 11.1 ± 4.4 mm in fetuses ≥23-week gestational age (n = 110) . None had bowel dilation. One of 115 fetuses had a simple form of anorectal malformation allowing complete repair in the neonatal period, but this fetus had a normal meconium column height on fetal MRI of 22 mm. The remaining 23/115 fetuses with lack of normal rectal meconium signal were born without evidence of anorectal malformation.
CONCLUSION
Decreased or absent T1-hyperintense rectal meconium signal in fetuses with open spinal dysraphism does not correlate with imperforate anus postnatal and may be a reflection of neurogenic bowel in this patient population.
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