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Complex Fetal Disorders: Effect of MR Imaging on Management-Preliminary Clinical Experience¹

¹ From the Departments of Radiology (F.V.C., H.H., R.A.F., A.J.B.) and Surgery, Fetal Treatment Center (M.R.H.), University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143-0628. From the 1998 RSNA scientific assembly. Received January 11, 1999; revision requested February 18; revision received March 10; accepted July 1. Address reprint requests to F.V.C. (e-mail: fergus.coakley@radiology.ucsf.edu).

PURPOSE: To determine the effect of magnetic resonance (MR) imaging findings on management of complex fetal disorders.

MATERIALS AND METHODS: MR imaging of the fetus was performed in 25 consecutive pregnant patients referred because of possible complex fetal disorders suspected on the basis of ultrasonographic (US) findings. Spoiled gradient-echo and single-shot rapid acquisition with relaxation enhancement MR imaging were performed in multiple planes anatomic to the fetus during maternal breath holding.

RESULTS: In the fetuses in 24 of 25 women, MR studies were technically satisfactory. MR imaging directly influenced fetal care in four (17%) of 24 cases by demonstrating congenital high airway obstruction syndrome, congenital hemochromatosis, unilateral cerebellar deficiency in association with congenital diaphragmatic hernia, and severe facial disfigurement due to a giant anterior neck mass. In eight (33%) cases, MR imaging provided supplementary findings, but did not affect fetal care. In 12 (50%) cases, MR imaging results confirmed US findings.

CONCLUSION: In cases of complex fetal disorders, MR imaging results can be used to supplement or confirm US findings and may directly affect management.

Index terms: Brain, hydrocephalus, 10.145 • Fetus, central nervous system, 153.141, 856.8744 • Fetus, gastrointestinal tract, 761.594, 856.14, 856.8754 • Fetus, MR, 856.121411, 856.121412 • Fetus, respiratory system, 67.141, 856.8759 • Fetus, US, 856.12981, 856.12983 • Hemochromatosis, 761.659, 856.8769 • Hernia, diaphragmatic, 856.8754 • Lung, congenital malformation, 67.141, 856.8759

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