1
|
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.
Collapse
|
2
|
Shulman M, Cho E, Aasi B, Cheng J, Nithiyanantham S, Waddell N, Sussman D. Quantitative analysis of fetal magnetic resonance phantoms and recommendations for an anthropomorphic motion phantom. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 33:257-272. [PMID: 31487004 DOI: 10.1007/s10334-019-00775-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/08/2019] [Accepted: 08/27/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To provide a review and quantitative analysis of the available fetal MR imaging phantoms. MATERIALS AND METHODS A literature search was conducted across Pubmed, Google Scholar, and Ryerson University Library databases to identify fetal MR imaging phantoms. Phantoms were graded on a semi-quantitative scale in regards to four evaluation categories: (1) anatomical accuracy in size and shape, (2) dielectric conductivity similar to the simulated tissue, (3) relaxation times similar to simulated tissue, and (4) physiological motion similar to fetal gross body, cardiovascular, and breathing motion. This was followed by statistical analysis to identify significant findings. RESULTS Seventeen fetal phantoms were identified and had an average overall percentage accuracy of 26%, with anatomical accuracy being satisfied the most (56%) and physiological motion the least (7%). Phantoms constructed using 3D printing were significantly more accurate than conventionally constructed phantoms. DISCUSSION Currently available fetal phantoms lack accuracy and motion simulation. 3D printing may lead to higher accuracy compared with traditional manufacturing. Future research needs to focus on properly simulating both fetal anatomy and physiological motion to produce a phantom that is appropriate for fetal MRI sequence development and optimization.
Collapse
Affiliation(s)
- Michael Shulman
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Eunyoung Cho
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Bipin Aasi
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Jin Cheng
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Saiee Nithiyanantham
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Nicole Waddell
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Dafna Sussman
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada. .,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada. .,The Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada. .,Department of Biomedical Physics, Ryerson University, Toronto, ON, M5B 2K3, Canada.
| |
Collapse
|
3
|
Kehl S, Becker L, Eckert S, Weiss C, Schaible T, Neff KW, Siemer J, Sütterlin M. Prediction of mortality and the need for neonatal extracorporeal membrane oxygenation therapy by 3-dimensional sonography and magnetic resonance imaging in fetuses with congenital diaphragmatic hernias. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:981-988. [PMID: 23716519 DOI: 10.7863/ultra.32.6.981] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To compare different rotation angles for assessment of fetal lung volume by 3-dimensional (3D) sonography with magnetic resonance imaging (MRI) regarding prediction of mortality and the need for neonatal extracorporeal membrane oxygenation (ECMO) therapy in fetuses with congenital diaphragmatic hernias. METHODS One hundred patients with fetal congenital diaphragmatic hernias between 22 and 39 weeks' gestation were examined by 3D sonography and MRI. Sonographic contralateral fetal lung volumes were assessed by the rotational technique (virtual organ computer-aided analysis) at 3 different rotation angles: 6°, 15°, and 30°. The MRI fetal lung volumes were calculated based on multiplanar T2-weighted MRI. To eliminate the influence of gestational age, the observed to expected contralateral fetal lung volume on sonography and the observed to expected fetal lung volume on MRI were calculated. Receiver operating characteristic (ROC) curves were calculated for the statistical prediction of survival and need for ECMO therapy by the observed to expected contralateral fetal lung volume (sonography) and observed to expected fetal lung volume (MRI). RESULTS One hundred cases were assessed for survival and 89 for ECMO necessity (11 neonates were not eligible for ECMO). For prediction of postpartum survival and ECMO necessity, the areas under the ROC curves (AUCs) showed very similar results for MRI and 3D sonography: observed to expected fetal lung volume by MRI, 0.819 (95% confidence interval, 0.730-0.909) and 0.835 (0.748-0.922), respectively; 6° sonography, 0.765 (0.647-0.883) and 0.820 (0.734-0.905); 15° sonography, 0.784 (0.672-0.896) and 0.811 (0.719-0.903); and 30° sonography, 0.732 (0.609-0.855) and 0.772 (0.671-0.872). Comparisons between the AUCs revealed no statistical differences. CONCLUSIONS We have shown the good prognostic value of 3D sonography in fetuses with congenital diaphragmatic hernias compared with MRI, particularly when using small rotation angles. Therefore, it can be an appropriate diagnostic tool when counseling patients for congenital diaphragmatic hernias.
Collapse
Affiliation(s)
- Sven Kehl
- Department of Obstetrics and Gynecology, Mannheim University Medical Center, Mannheim, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Kehl S, Kalk AL, Eckert S, Schaible T, Sütterlin M, Neff W, Siemer J. Assessment of lung volume by 3-dimensional sonography and magnetic resonance imaging in fetuses with congenital diaphragmatic hernias. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:1539-1545. [PMID: 22039026 DOI: 10.7863/jum.2011.30.11.1539] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the influence of different rotation angles in assessment of the contralateral lung volume by 3-dimensional (3D) sonography in comparison to magnetic resonance imaging (MRI) in fetuses with congenital diaphragmatic hernias. METHODS A total of 126 measurements by 3D sonography and MRI were conducted in 81 patients between 18 and 39 weeks' gestation. The 3D sonographic volumes of the contralateral fetal lung were calculated by the rotational technique (virtual organ computer-aided analysis) with rotation angles of 6°, 15°, and 30°. Transverse multiplanar T2-weighted MRI was performed for the MRI measurements. To compare the accuracy of 3D sonographic volumetry using different rotation angles, MRI assessment was taken as the reference method, and percentage errors and limits of agreement were calculated for each angle. RESULTS Three-dimensional sonographic volume measurements showed a high correlation with MRI (6° angle, R(2) = 0.86; 15° angle, R(2) = 0.78; 30° angle, R(2) = 0.68). The mean percentage error showed no systematic error. With regard to random error, the 6° step had significantly lower values than the larger angles 30° step (R = 0.472) and the narrowest limits of agreement. CONCLUSIONS Especially when using a small rotation angle, assessment of the contralateral fetal lung volume by 3D sonography in congenital diaphragmatic hernias is a reliable alternative to MRI.
Collapse
Affiliation(s)
- Sven Kehl
- Departments of Obstetrics and Gynecology, Mannheim University Medical Center, Heidelberg University, Mannheim, Germany.
| | | | | | | | | | | | | |
Collapse
|