Sahar Saleem MD, Presenter: Nothing to Disclose

Eman A. Elkattan MBBCh, MD, Abstract Co-Author: Nothing to Disclose

Ahmed K Abdel-Hakeem MBBCh,MD, Abstract Co-Author: Nothing to Disclose

Maha S. Zaki MD, Abstract Co-Author: Nothing to Disclose

To describe the in-utero MRI features of fetuses referred with sonographically suspected multiple congenital abnormalities and if MRI can further help to identify fetal syndromes.

We studied with MRI 90 fetuses (86 singleton & 4 twins) sonographically diagnosed with suspected multiple congenital abnormalities an average gestational age of 25.5 weeks (SD 5.8). MRI was obtained along fetal brain and body planes using T1- & T2-weighted sequences. Forty-five pregnancies continued to term and 45 pregnancies were interrupted. MRI findings were correlated with Outcome measures: autopsy/pathology (n= 28) , postnatal imaging (n=42), postmortem plain x-ray/MRI/CT (n=13), amniocentesis (viral and karyotype) (n=52), and surgery (n=3).

Prenatal imaging identified 13 oligohydramnios and 12 polyhydramnios pregnancies. Outcome measures confirmed combination of multiple congenital abnormalities in the studied 90 fetuses that involved their CNS (n=62), cardiovascular (n=22), skeletal (n=20), urinary tract (n=19), craniofacial (n=9), pulmonary (n=8), liver and/or spleen (n=5), gastrointestinal (2), soft tissues (6), and pleural effusion/pericardial effusion/ascites (n=7). In correlation with outcome measures, fetal MRI correctly confirmed US diagnosis in 26 (28.9%) fetuses, added findings that significantly modified prenatal diagnosis and in 41 cases (45.6%), added findings but did not influence diagnosis in 13 (14%), and missed findings shown by US in 7 (8%): both US and MRI failed to diagnose two cases prenatally (2.2 %). Most US-occult findings that were added by fetal MRI were related to CNS (n=35). Fetal MRI helped to refine diagnosis of fetal sydnromes such as Pena-Shokeir, Tectocerebellar dysraphia, pontocerebellar hypoplasia-skeletal dysmorphism, Mardern-Walker syndrome and Tuberous sclerosis  

Fetal MRI may help in making a precise prenatal diagnosis of fetuses with multiple congenital anomalies important for determining the etiology, prognosis, recurrence risk, and options of pregnancy management.  

Adding MRI to the prenatal work up of suspected multiple fetal anomalies may help to refine diagnosis of fetal syndromes.

Saleem, S, Elkattan, E, Abdel-Hakeem, A, Zaki, M, Magnetic Resonance Imaging of Fetuses with Multiple Congenital Abnormalities .  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11017021.html