Anne Hubbard MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: OBJECTIVE: Evaluate prenatal magnetic resonance imaging (MRI) of sacrococcygeal teratoma (SCT). Determine if MRI provides additional information compared to prenatal ultrasonography US). Methods and Materials: MATERIAL AND METHODS: Twenty-two pregnant women were referred for prenatal MRI of SCT. US and MRI were performed the same day at a single institution. The size, location, characteristics, and compressive effects of the tumor were determined and correlated with US and postnatal results. Results: RESULTS: The mean gestational age at MRI evaluation was 23 wk (range, 19 to 33). American Academy of Pediatrics, Surgical Section classification were type I in 5 patients, type II in 14, type III in 3, and type IV none. The SCT appeared cystic with few septa in 2 fetuses, markedly septated in 3, microcystic in 1, mixed cystic-solid in 12 and solid in 4. MRI results were in agreement with US results in all fetuses for the diagnosis of SCT. Obstruction of the urinary tract was seen in 41% on MRI and US. MRI alone visualized the rectum in all fetuses. MRI only showed rectal displacement (n=11), dilated vagina (n=1) and intraspinal extension (n=2). In fetuses with SCT type II and III, MRI better demonstrated the cephalic extent of the tumor compared to US. MRI diagnoses were confirmed at surgery or autopsy in all patients. Fetal demise occurred in 4, cardiac failure (n=3), in utero tumor rupture (n=1). Three fetuses with high output cardiac physiology underwent open fetal surgery at 21, 24, and 26 weeks gestational age with two survivors. Conclusion: CONCLUSION: SCT had characteristic MRI appearances that allowed a complete assessment in all fetuses. MRI more accurately showed intrapelvic/abdominal extent of tumor, compressive effect on genitourinary tract, and intraspinal extension. The MRI results affected treatment,counseling of patients and the planning of surgical resection.      

Hubbard MD, A, Diagnosis and Characterization of Fetal Sacrococcygeal Teratoma with Prenatal MR Imaging.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3106764.html