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Abdelhalim A, Hafez AT. Antenatal and postnatal management of posterior urethral valves: where do we stand? AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00238-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Posterior urethral valve (PUV) is the leading etiology of lower urinary tract obstruction (LUTO) in boys and is an important cause of end-stage renal disease (ESRD) in children. The aim of this article is to review the current status on antenatal intervention for PUV as well as postnatal medical and surgical management.
Main body
MEDLINE, EMBASE, Pubmed and Google Scholar search was conducted throughout December 2020 using the keywords: posterior urethral valves, congenital urinary obstruction, antenatal, valve bladder syndrome, medical, anticholinergics, alpha blocker, antibiotics, biofeedback, diversion, augmentation cystoplasty and renal transplantation. Only papers written in English were included. The relevant literature was summarized. Despite advances in antenatal intervention for fetal LUTO, it remains associated with considerable fetal and maternal morbidity. Patient selection criteria for antenatal intervention are greatly debated. Fetal intervention has resulted in improved perinatal survival in properly selected cases, with a questionable benefit to postnatal renal function. There is decent evidence supporting the use of anticholinergics in infants and young children following valve ablation, with less robust evidence advocating alpha blockers, overnight catheter drainage and biofeedback. The role of urinary diversion remains contentious. Optimizing bladder dynamics is crucial for successful renal transplantation outcomes.
Conclusion
While antenatal intervention has failed to improve renal function outcomes of PUV, patient-centered medical and sometimes surgical interventions can help delay the progression of chronic kidney disease. Lifelong monitoring and management of the associated bladder dysfunction is indispensable even after successful renal transplantation.
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2
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Masselli G, Cozzi D, Ceccanti S, Laghi F, Giancotti A, Brunelli R. Fetal body MRI for fetal and perinatal management. Clin Radiol 2021; 76:708.e1-708.e8. [PMID: 34112509 DOI: 10.1016/j.crad.2021.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/05/2021] [Indexed: 12/19/2022]
Abstract
Fetal magnetic resonance imaging (MRI) has become a valuable adjunct to ultrasound (US) in diagnosing fetal abnormalities. This review is intended to highlight the contribution of MRI in parental counselling and perinatal treatment. A state-of-the-art fetal MRI protocol with experts of maternal-fetal medicine present in the MRI suite allows emphasis on patient-centred care and maximises therapeutic options.
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Affiliation(s)
- G Masselli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
| | - D Cozzi
- Pediatric Surgery Unit, Sapienza University of Rome, Azienda Policlinico Umberto I, Rome, Italy
| | - S Ceccanti
- Pediatric Surgery Unit, Sapienza University of Rome, Azienda Policlinico Umberto I, Rome, Italy
| | - F Laghi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - A Giancotti
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
| | - R Brunelli
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
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3
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Current State of Fetal Intervention for Obstructive Uropathy–Focus on Bladder. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-020-00600-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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4
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Abstract
Importance Bilateral renal agenesis is a rare congenital anomaly associated with poor prognosis. Objective The aims of this article are to review and summarize evidence on prenatal diagnosis and outcomes of bilateral renal agenesis. Evidence Acquisition A search was undertaken using PubMed and ClinicalTrials.gov databases from January 1, 1998, to September 1, 2018. Search terms include "prenatal diagnosis" OR "outcomes" AND "bilateral renal agenesis." Search was limited to English language. Results Fetal ultrasonography is the primary imaging modality for prenatal diagnosis of fetal urogenital tract abnormalities. However, ultrasonography is limited by several factors; it is operator dependent and associated with small field of view, has limited soft-tissue acoustic contrast, and is also influenced by patient habitus and fetal position. Color Doppler ultrasonography can be used as an adjunct to exclude bilateral renal agenesis by visualizing renal arteries. In the literature, prenatal magnetic resonance imaging has been reported to be equal to or superior to prenatal ultrasonography. Bilateral renal agenesis with oligohydramnios/anhydramnios is associated with a poor prognosis; perinatal death occurs secondary to pulmonary hypoplasia in the majority of cases. Conclusions Ultrasonography in combination with color Doppler ultrasonography permits the fetal urinary tract to be assessed in the first and early second trimester of gestation. The magnetic resonance imaging can be used as a complementary adjunctive modality in equivocal or inconclusive ultrasonographic findings.
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Chalouhi GE, Millischer AÉ, Mahallati H, Siauve N, Melbourne A, Grevent D, Vinit N, Heidet L, Aigrain Y, Ville Y, Blanc T, Salomon LJ. The use of fetal MRI for renal and urogenital tract anomalies. Prenat Diagn 2019; 40:100-109. [PMID: 31736096 DOI: 10.1002/pd.5610] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 12/20/2022]
Abstract
Fetal anomalies are detected in approximately 2% of all fetuses and, among these, genitourinary tract abnormalities account for 30% to 50% of all structural anomalies present at birth. Although ultrasound remains the first line diagnostic modality, fetal MRI provides important additional structural and functional information, especially with the development of faster sequences and the use of functional sequences. The added value of MRI-based imaging is three-fold: (a) improvement of diagnostic accuracy by adequate morphological examination, (b) detection of additional anomalies, and (c) in addition, MRI has the potential to provide information regarding renal function. In this review, we describe the role of fetal MRI in the anatomical evaluation of renal and urogenital tract anomalies, and we also touch upon the contribution of functional MRI to the diagnostic workup of these conditions.
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Affiliation(s)
- Gihad E Chalouhi
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Division of Fetal Medicine, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon.,Université de Paris, Paris, France
| | - Anne-Élodie Millischer
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Houman Mahallati
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Department of Radiology, University of Calgary, Calgary, Canada
| | - Nathalie Siauve
- Imagerie Médicale, Hôpital Louis Mourier APHP, Colombes, France
| | - Andrew Melbourne
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - David Grevent
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Nicolas Vinit
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France
| | - Laurence Heidet
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Pediatric Nephrology Department, Hôpital Universitaire Necker-Enfants Malades, Sorbonne Paris Cité University, Paris, France
| | - Yves Aigrain
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France
| | - Yves Ville
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Thomas Blanc
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France.,INSERM U1151-CNRS UMR 8253, Université de Paris, Institut Necker-Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | - Laurent J Salomon
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Université de Paris, Paris, France
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Ji H, Dong SZ. Prenatal diagnosis of renal duplication by magnetic resonance imaging. J Matern Fetal Neonatal Med 2018; 33:2342-2347. [PMID: 30572758 DOI: 10.1080/14767058.2018.1548603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To determine the value of fetal magnetic resonance imaging (MRI) to detect renal duplication.Methods: In this retrospective study, prenatal MRI and ultrasound (US) diagnoses were compared with postnatal imaging and/or surgical data. Twenty-six pregnant women (average age, 32 years; range, 29-36 years) underwent MRI at a mean gestational age of 25 weeks (range, 21-33 weeks). MRI was performed with a 1.5-T unit within 1 week after prenatal ultrasound examination. The steady-state free-precession (SSFP), single-shot turbo spin echo (SSTSE), and T1-weighted fast imaging sequences were used.Results: Twenty-four cases of fetal renal duplications diagnosed using prenatal MRI were judged to be correct when compared with postnatal imaging and surgical follow-up. In 18 of 26 cases, the diagnoses established using prenatal US were correct when compared with postnatal diagnosis. In 2 of 26 cases, the diagnosis with both prenatal US and MRI were not entirely correct when compared with postnatal diagnosis. In the two cases, magnetic resonance (MR) identified left two pelvicalyceal systems but could not found ipsilateral ectopic ureteral orifice, US only found left hydronephrosis but could not found duplex collection system. In other six cases, MR corrected the US diagnosis by providing a more accurate renal morphology or additional diagnostic information.Conclusions: MRI is an effective method for the diagnosis of fetal duplex kidney deformity and associated ureteral and other abnormalities.
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Affiliation(s)
- Hui Ji
- Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Su-Zhen Dong
- Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
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7
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Magnetic resonance imaging for evaluation of foetal multicystic dysplastic kidney. Eur J Radiol 2018; 108:128-132. [PMID: 30396644 DOI: 10.1016/j.ejrad.2018.09.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 11/18/2022]
Abstract
We sought to evaluate the diagnostic value of foetal magnetic resonance imaging (MRI) for multicystic dysplastic kidney (MCDK) disease. We retrospectively identified 55 foetuses with MCDK diagnosed (51 unilateral; 4 bilateral) by foetal MRI. We analysed the anatomical findings by prenatal MRI and compared them with the prenatal ultrasound (US) and postnatal findings. Additional diagnostic information added by MRI was recorded. The gestational age of the 55 foetuses ranged from 22 to 35 weeks (mean, 26.5 ± 3.6 weeks). The age of the pregnant women ranged from 23 to 40 years (mean, 31 ± 4.2 years). All 55 cases were performed at 1.5 T magnetic resonance unit. MRI sequences, including steady-state free precession (SSFP), single-shot fast spin echo (SSFSE), T1-weighted imaging (T1WI), and diffusion weighted imaging (DWI) sequences. Follow-up was obtained for 53 cases (2 cases of autopsy, 51 cases of postnatal imaging or surgery confirmed). Among the 51 unilateral cases, 16 cases were associated with other urinary tract anomalies, 3 cases with extra-renal anomalies, and the remaining 32 cases without associated anomalies. 2 of 16 cases with contralateral renal agenesis were with oligohydramnios and pulmonary hypoplasia. 2 of 4 bilateral MCDK presented with oligohydramnios and pulmonary hypoplasia. 52 of 53 cases were correctly diagnosed by MRI compared with the final diagnoses; 40 of 53 (75.5%) cases were correctly diagnosed by prenatal ultrasound. Both prenatal ultrasound and MRI failed to correctly diagnose one case bilateral MCDK, and MRI correctly changed the ultrasound diagnosis in 12 cases. Foetal MRI can add additional diagnostic information to prenatal US in the assessment of MCDK, even change the prenatal counselling and decisions.
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8
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Abstract
PURPOSE OF THE REVIEW In this article, we explore the origins of intervention of fetal lower urinary tract obstruction, and we specifically discuss the background and recent outcomes of vesicoamniotic shunt placement and fetal cystoscopy. The article seeks to provide a comprehensive overview of the field while bringing the reader quickly up to speed on the pertinent literature and the critical data that are available to guide decision-making regarding intervention. RECENT FINDINGS Appropriate patient selection for fetal intervention remains challenging despite advances in prenatal imaging. Both a randomized controlled trial and multiple systematic reviews show evidence of a perinatal survival benefit following fetal intervention but rates of renal morbidity remain very high. Despite 30 years of research, fetal lower urinary tract obstruction remains a difficulty entity to treat. Intervention may lead to survival, but physicians and caregivers must remain alert for the distinct possibility of long-term renal morbidity in survivors.
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Affiliation(s)
- Douglass B Clayton
- Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, 2200 Children's Way, 4102 Doctor's Office Tower, Nashville, TN, 37232, USA.
| | - John W Brock
- Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, 2200 Children's Way, 4102 Doctor's Office Tower, Nashville, TN, 37232, USA
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9
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Ruano R, Dunn T, Braun MC, Angelo JR, Safdar A. Lower urinary tract obstruction: fetal intervention based on prenatal staging. Pediatr Nephrol 2017; 32:1871-1878. [PMID: 28730376 DOI: 10.1007/s00467-017-3593-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/28/2016] [Accepted: 12/30/2016] [Indexed: 11/25/2022]
Abstract
The authors present an overview of lower urinary tract obstruction (LUTO) in the fetus with a particular focus on the insult to the developing renal system. Diagnostic criteria along with the challenges in estimating long-term prognosis are reviewed. A proposed prenatal LUTO disease severity classification to guide management decisions with fetal intervention to maintain or salvage in utero and neonatal pulmonary and renal function is also discussed. Stage I LUTO (mild form) is characterized by normal amniotic fluid index after 18 weeks, normal kidney echogenicity, no renal cortical cysts, no evidence of renal dysplasia, and favorable urinary biochemistries when sampled between 18 and 30 weeks; prenatal surveillance is recommended. Stage II LUTO is characterized by oligohydramnios/anhydramnios, hyperechogenic kidneys but absent renal cortical cysts or apparent signs of renal dysplasia and favorable fetal urinary biochemistry; fetal vesicoamniotic shunting (VAS) or fetal cystoscopy is indicated to prevent pulmonary hypoplasia and renal failure. Stage III LUTO is oligohydramnios/anhydramnios, hyperechogenic kidneys with cortical cysts and renal dysplasia and unfavorable fetal urinary biochemistry after serial evaluation; fetal vesicoamniotic shunt may prevent severe pulmonary hypoplasia but not renal failure. Stage IV is characterized by intrauterine fetal renal failure, defined by anhydramnios and ultrasound (US) findings suggestive of severe renal dysplasia, and is associated with death in 24 h of life or end-stage renal disease (ESRD) within the first week of life; fetal vesicoamniotic shunt and fetal cystoscopy are not indicated.
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Affiliation(s)
- Rodrigo Ruano
- Department of Obstetrics and Gynecology, Mayo Clinic Fetal Diagnostic and Therapeutic Center, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Timothy Dunn
- Renal Section, Baylor College of Medicine and Texas Children's Fetal Center - Texas Children's Hospital Pavilion for Women, Houston, TX, USA
| | - Michael C Braun
- Renal Section, Baylor College of Medicine and Texas Children's Fetal Center - Texas Children's Hospital Pavilion for Women, Houston, TX, USA
| | - Joseph R Angelo
- Renal Section, Baylor College of Medicine and Texas Children's Fetal Center - Texas Children's Hospital Pavilion for Women, Houston, TX, USA
| | - Adnan Safdar
- Renal Section, Baylor College of Medicine and Texas Children's Fetal Center - Texas Children's Hospital Pavilion for Women, Houston, TX, USA
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10
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Hamdaoui N, Dabadie A, Lesieur E, Quarello E, Kheiri M, Hery G, Guidicelli B, Bretelle F, Gorincour G. [Ultrasound of the fetal urinary system during the first trimester of pregnancy]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2017; 45:373-380. [PMID: 28552751 DOI: 10.1016/j.gofs.2017.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/02/2017] [Indexed: 12/27/2022]
Abstract
The detection of abnormalities of the fetal urinary system in the first trimester of pregnancy is constantly improving, namely owing to the improved resolution of the image, the use of the endovaginal approach and thanks to sonographers' constant training. The pathological aspects, usually detected in the second trimester of pregnancy, can be suspected early in the first trimester and range from kidneys' cavity dilation to bilateral renal agenesis, polycystic kidney disease, multi-cystic dysplasia and bladder megavessia or bladder exstrophy. A poly-malformative syndrome is to be found out. The detection of an abnormality of the urinary tract requires a close ultrasound check. Very often, the pathological aspects tend to disappear spontaneously. In particular, the non-visualization of the bladder requires repeated examinations during the same session or even a little later in the pregnancy. We will carry out a review of the literature by pointing out the usual and unusual aspects of the fetal urinary system visible in the first trimester and we will as well propose an algorithm describing how to deal with abnormalities of the urinary tract that can be found out at first trimester ultrasound.
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Affiliation(s)
- N Hamdaoui
- Centre de diagnostic prénatal, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - A Dabadie
- Service d'imagerie pédiatrique et prénatale, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France
| | - E Lesieur
- Centre de diagnostic prénatal, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France
| | - E Quarello
- Département d'échographies obstétricales, fondation-hôpital Saint-Joseph, 26, boulevard de Louvain, 13008 Marseille, France; Institut de médecine de la reproduction, 6, rue Rocca, 13008 Marseille, France
| | - M Kheiri
- Service d'imagerie pédiatrique et prénatale, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France
| | - G Hery
- Centre de diagnostic prénatal, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France; Service de chirurgie pédiatrique, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France
| | - B Guidicelli
- Centre de diagnostic prénatal, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France
| | - F Bretelle
- Centre de diagnostic prénatal, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France
| | - G Gorincour
- Centre de diagnostic prénatal, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France; Service d'imagerie pédiatrique et prénatale, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France
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Faure A, Panait N, Panuel M, Alessandrini P, D'Ercole C, Chaumoitre K, Merrot T. Predicting postnatal renal function of prenatally detected posterior urethral valves using fetal diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient determination. Prenat Diagn 2017; 37:666-672. [DOI: 10.1002/pd.5063] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 03/29/2017] [Accepted: 04/21/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Alice Faure
- Aix-Marseille Université; Marseille France
- Paediatric Surgery Department; APHM, CHU Hopital Nord; Marseille France
| | - Nicoleta Panait
- Aix-Marseille Université; Marseille France
- Paediatric Surgery Department; APHM, CHU Hopital Nord; Marseille France
| | - Michel Panuel
- Aix-Marseille Université; Marseille France
- Medical Imaging Department; APHM, CHU Hopital Nord; Marseille France
| | - Pierre Alessandrini
- Aix-Marseille Université; Marseille France
- Paediatric Surgery Department; APHM, CHU Hopital Nord; Marseille France
| | - Claude D'Ercole
- Aix-Marseille Université; Marseille France
- Gynecologic & Obstetrical Department; APHM, CHU Hopital Nord; Marseille France
| | - Kathia Chaumoitre
- Aix-Marseille Université; Marseille France
- Medical Imaging Department; APHM, CHU Hopital Nord; Marseille France
| | - Thierry Merrot
- Aix-Marseille Université; Marseille France
- Paediatric Surgery Department; APHM, CHU Hopital Nord; Marseille France
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Dabadie A, Quarello E, Degardin N, Desbriere R, Heckenroth H, Sigaudy S, Gorincour G. Added value of MRI for the prenatal diagnosis of isolated orofacial clefts and comparison with ultrasound. Diagn Interv Imaging 2016; 97:915-21. [DOI: 10.1016/j.diii.2015.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 09/03/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
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13
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[Segmental approach to congenital heart diseases: Principles and applications to prenatal imaging]. ACTA ACUST UNITED AC 2016; 44:428-34. [PMID: 27451065 DOI: 10.1016/j.gyobfe.2016.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 06/03/2016] [Indexed: 11/21/2022]
Abstract
This pictorial essay will initially present the origin, definitions, objectives and main principles of the segmental approach to congenital heart diseases. Then, through ultrasound scans iconography we will consider its practical applications to prenatal screening. Eventually, through both ultrasound and MRI cases, we will discuss its potential use in fetal diagnostic evaluation.
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