Ultrafast MRI of the fetus
Christine M Glastonbury
Department of Radiology, University Hospital, Salt Lake City, Utah, USA
Search for more papers by this authorAnne M Kennedy
Department of Radiology, University Hospital, Salt Lake City, Utah, USA
Search for more papers by this authorChristine M Glastonbury
Department of Radiology, University Hospital, Salt Lake City, Utah, USA
Search for more papers by this authorAnne M Kennedy
Department of Radiology, University Hospital, Salt Lake City, Utah, USA
Search for more papers by this authorCM Glastonbury MB BS, FRANZCR; AM Kennedy MRCP, FRCR.
SUMMARY
During the last decade there has been increasing interest in MRI for the evaluation of ultrasound-detected fetal abnormalities. Motion artefacts previously precluded detailed imaging, but this is now possible using single-shot rapid acquisition sequences. These ultrafast techniques with subsecond images capture ‘snap-shot’ views of the fetus. By virtue of the infinitely long relaxation time (TR) these images are heavily T2-weighted so that fluid around and within the fetus delineates the anatomy.
Currently, fetal MRI has shown to be most beneficial in the investigation of cerebral abnormalities suspected from sonography, and in the detection of subtle associated anomalies. It clearly has a role in the evaluation of complex somatic abnormalities, and is helpful in the evaluation of fetuses prior to surgery.
We present a pictorial review of our experience with single-shot fast spin-echo (SSFSE) imaging, demonstrating normal anatomy of the fetal brain and body. In addition we present cerebral and somatic abnormalities to illustrate cases where we have found fetal MRI to be a useful adjunct to sonography.
REFERENCES
- 1 Smith FW, Adam AH, Phillips WD. NMR imaging in pregnancy. Lancet 1983; 1: 61–2.
- 2 Johnson IR, Symonds EM, Kean DM et al. Imaging the pregnant human uterus with nuclear magnetic resonance. Am J Obstet Gynecol 1984; 148: 1136–9.
- 3 McCarthy SM, Filly RA, Stark DD et al. Magnetic resonance imaging of fetal anomalies in utero: Early experience. AJR 1985; 145: 677–82.
- 4 Yamashita Y, Namimoto T, Abe Y et al. MR imaging of the fetus by a HASTE sequence. AJR 1997; 168: 513–19.
- 5 Stehling MK, Mansfield P, Ordidge RJ et al. Echo-planar imaging of the human fetus in utero. Magn Reson Med 1990; 13: 314–18.
- 6 Coakley FV, Hricak H, Filly RA, Barkovich AJ, Harrison MR. Complex fetal disorders: Effect of MR imaging on management—preliminary clinical experience. Radiology 1999; 213: 691–6.
- 7 Levine D, Barnes PD, Sher S et al. Fetal fast MR imaging: Reproducibility, technical quality, and conspicuity of anatomy. Radiology 1998; 206: 549–54.
- 8
Kubik-Huch RA,
Wisser J,
Stallmach T
et al.
Prenatal diagnosis of fetal malformations by ultrafast magnetic resonance imaging.
Prenat Diagn
1998; 18: 1205–8.
10.1002/(SICI)1097-0223(199811)18:11<1205::AID-PD429>3.0.CO;2-B CAS PubMed Web of Science® Google Scholar
- 9 Levine D, Barnes PD, Edelman RR. Obstetric MR imaging. Radiology 1999; 211: 609–17.
- 10 Coakley FV. Role of magnetic resonance imaging in fetal surgery. Top Magn Reson Imaging 2001; 12: 39–51.
- 11 Myers C, Duncan KR, Gowland PA, Johnson IR, Baker PN. Failure to detect intrauterine growth restriction following in utero exposure to MRI. Br J Radiol 1998; 71: 549–51.
- 12 Baker PN, Johnson IR, Harvey PR, Gowland PA, Mansfield P. A three-year follow-up of children imaged in utero with echo-planar magnetic resonance. Am J Obstet Gynecol 1994; 170: 32–3.
- 13 International Non-Ionizing Radiation Committee of the International Radiation Protection Association. Protection of the patient undergoing a magnetic resonance examination. Health Phys 1991; 61: 923–8.
- 14 Colletti PM, Sylvestre PB. Magnetic resonance imaging in pregnancy. Magn Reson Imaging Clin N Am 1994; 2: 291–307.
- 15 Levine D, Barnes PD, Madsen JR et al. Fetal CNS anomalies revealed on ultrafast MR imaging. AJR 1999; 172: 813–18.
- 16 Sonigo PC, Rypens FF, Carteret M, Delezoide AL, Brunelle FO. MR imaging of fetal cerebral anomalies. Pediatr Radiol 1998; 28: 212–22.
- 17 Garel C, Brisse H, Sebag G et al. Magnetic resonance imaging of the fetus. Pediatr Radiol 1998; 28: 201–11.
- 18 Levine D, Barnes PD, Madsen JR, Li W, Edelman RR. Fetal central nervous system anomalies: MR imaging augments sonographic diagnosis. Radiology 1997; 204: 635–42.
- 19 Simon EM, Goldstein RB, Coakley FV et al. Fast MR imaging of fetal CNS anomalies in utero. AJNR 2000; 21: 1688–98.
- 20 Levine D, Barnes PD. Cortical maturation in normal and abnormal fetuses as assessed with prenatal MR imaging. Radiology 1999; 210: 751–8.
- 21 Lan LM, Yamashita Y, Tang Y et al. Normal fetal brain development: MR imaging with a half-Fourier rapid acquisition with relaxation enhancement sequence. Radiology 2000; 215: 205–10.
- 22 Garel C, Chantrel E, Brisse H et al. Fetal cerebral Cortex: Normal gestational landmarks identified using prenatal MR imaging. AJNR 2001; 22: 184–9.
- 23 Stazzone MM, Hubbard AM, Bilaniuk LT et al. Ultrafast MR imaging of the normal posterior fossa in fetuses. AJR 2000; 175: 835–9.
- 24 Bilaniuk LT. Magnetic resonance imaging of the fetal brain. Semin Roentgenol 1999; 34: 48–61.
- 25 Resta M, Burdi N, Medicamento N. Magnetic resonance imaging of normal and pathologic fetal brain. Childs Nerv Syst 1998; 14: 151–4.
- 26 Hubbard AM, Harty P. Prenatal magnetic resonance imaging of fetal anomalies. Semin Roentgenol 1999; 34: 41–7.
- 27 Bilaniuk LT, Zimmerman RA, Hunter JV. MRI of fetuses with in utero repair of myelomeningoceles. (Abst). Radiological Society of North America, November 2001.
- 28 Green PM, Wilson H, Romaniuk C, May P, Welch CR. Idiopathic intracranial haemorrhage in the fetus. Fetal Diagn Ther 1999; 14: 275–8.
- 29 Kirkinen P, Partanen K, Ryynanen M, Orden MR. Fetal intracranial hemorrhage. Imaging by ultrasound and magnetic resonance imaging. J Reprod Med 1997; 42: 467–72.
- 30 Fusch C, Ozdoba C, Kuhn P et al. Perinatal ultrasonography and magnetic resonance imaging findings in congenital hydrocephalus associated with fetal intraventricular hemorrhage. Am J Obstet Gynecol 1997; 177: 512–18.
- 31 Campi A, Scotti G, Filippi M et al. Antenatal diagnosis of vein of Galen aneurysmal malformation: MR study of fetal brain and postnatal follow-up. Neuroradiology 1996; 38: 87–90.
- 32 Kultursay N, Gelal F, Mutluer S et al. Antenatally diagnosed neonatal craniopharyngioma. J Perinatol 1995; 15: 426–8.
- 33 Peng SS, Shih JC, Liu HM, Li YW, Hsieh FJ. Ultrafast fetal MR images of intracranial teratoma. J Comput Assist Tomogr 1999; 23: 318–19.
- 34 Guibaud L, Champion F, Buenerd A et al. Fetal intraventricular glioblastoma: ultrasonographic, magnetic resonance imaging, and pathologic findings. J Ultrasound Med 1997; 16: 285–8.
- 35 Hubbard AM, Adzick NS, Crombleholme TM et al. Congenital chest lesions: Diagnosis and characterization with prenatal MR imaging. Radiology 1999; 212: 43–8.
- 36 Poutamo J, Vanninen R, Partanen K, Kirkinen P. Diagnosing fetal urinary tract abnormalities: benefits of MRI compared to ultrasonography. Acta Obstet Gynecol Scand 2000; 79: 65–71.
- 37 Spielmann AL, Freed KS, Spritzer CE. MRI of conjoined twins illustrating advances in fetal imaging. J Comput Assist Tomogr 2001; 25: 88–90.
- 38 Poutamo J, Vanninen R, Partanen K, Ryynanen, Kirkinen P. Magnetic resonance imaging supplements ultrasonographic imaging of the posterior fossa, pharynx and neck in malformed fetuses. Ultrasound Obstet Gynecol 1999; 13: 327–34.
- 39 Coakley FV, Lopoo JB, Lu Y et al. Normal and hypoplastic fetal lungs: Volumetric assessment with prenatal single-shot rapid acquisition with relaxation enhancement MR imaging. Radiology 2000; 216: 107–11.
- 40 Leung JW, Coakley FV, Hricak H et al. Prenatal MR imaging of congenital diaphragmatic hernia. AJR 2000; 174: 1607–12.
- 41 Hubbard AM, Crombleholme TM, Adzick NS et al. Prenatal MRI evaluation of congenital diaphragmatic hernia. Am J Perinatol 1999; 16: 407–13.