Hollie Anne Jackson MD, Presenter: Nothing to Disclose

Ashok Panigrahy MD, Abstract Co-Author: Nothing to Disclose

Cornelia Kaminsky MD, Abstract Co-Author: Nothing to Disclose

Fariba Goodarzian MD, Abstract Co-Author: Nothing to Disclose

Sunny Pearson, Abstract Co-Author: Nothing to Disclose

David Miller, Abstract Co-Author: Nothing to Disclose

To demonstrate the advantage of heavily T2-weighted MR imaging (MR hydrography) for the evaluation of prenatal chest lesions over standard T2-weighted single shot fast spin echo (SSFSE) imaging

Standard T2 SSFSE and heavily weighted T2 single shot FSE imaging (hydrographic technique) was performed in 100 consecutive studies in patients with abnormal sonographic findings. Ten chest lesions were identified in these patients. Increased T2-weighting was achieved by prolonging the effective echo time (TEeff) from 70 ms to 488 ms. A slice thickness of 3mm was used.Three board certified pediatric radiologists evaluated images. It was noted whether heavy T2-weighted imaging (i) changed in the primary diagnosis; (ii) provided additional characterization; (iii) increased confidence in the diagnosis; and (iv) improved conspicuity of the lesions. A three point scale was used to evaluate the conspicuity of the lesion: -1=less conspicuous than the standard SSFSE; 0= as conspicuous as the standard SSFSE and +1=more conspicuous than the standard SSFSE and a binomial sign test used for statistical analysis. Also, maximum cross section areas and volumes of the lesion were determined by manual placement of boundary contours using a PACS system.

The standard SSFSE imaging determined 9/10 of the chest lesion to represent CCAMs and 1/10 lesion to be pulmonary sequestration. For all chest lesions examined, the heavy T2 imaging did not change the diagnosis which was initially determined by the SSFSE imaging. Hydrographic imaging did improve the ability to see smaller cystic lesion in a subset of CCAM cases and increased the confidence in the diagnosis in all cases. The conspicuity of the lesion was improved using the hydrographic imaging (p< 0.05). The volumetric and cross sectional area measurements of the chest lesions did not differ significantly between the hydrographic imaging and standard SSFSE imaging.

MR hydrography can improve both conspicuity and characterization of congenital chest lesions.

MR hydrography can increase confidence in the diagnosis, but does not change initial diagnosis in evaluating fetal chest lesions when compared to standard T2 SSFSE imaging.

Jackson, H, Panigrahy, A, Kaminsky, C, Goodarzian, F, Pearson, S, Miller, D, MR Imaging of Fetal Chest Lesions: Use of a Heavy T2-weighted Single Shot Fast Spin Echo Sequence (MR Hydrography).  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5014565.html