Zusammenfassung
Klinisches/methodisches Problem
Diagnose und Differenzialdiagnose fetaler thorakaler und abdomineller Malformationen.
Radiologische Standardverfahren
Ultraschall, MRT.
Methodische Innovationen
MRT zur weiteren Abklärung und genaueren Differenzierung bei vielen im Ultraschall gestellten Verdachtsdiagnosen.
Leistungsfähigkeit
Verbesserte anatomische Darstellung mittels MRT und Darstellung unterschiedlicher Gewebezusammensetzung mittels verschiedener MR-Sequenzen.
Bewertung
Die fetale MRT ist bei der angegebenen Fragestellung in die klinische Routine eingegangen und liefert weiterhin die Basis für wissenschaftliche Untersuchungen in diesem Bereich.
Empfehlung für die Praxis
Die fetale MRT liefert beim Vorliegen thorakaler oder abdomineller Malformationen komplementär zum Ultraschall wichtige Zusatzinformationen, um die diagnostische Genauigkeit zu erhöhen, die Prognoseabschätzung zu verbessern und ggf. eine bessere chirurgische Planung zu ermöglichen.
Abstract
Clinical/methodical issue
Diagnosis and differential diagnosis of fetal thoracic and abdominal malformations.
Standard radiological methods
Ultrasound and magnetic resonance imaging (MRI).
Methodical innovations
In cases of suspected pathologies based on fetal ultrasound MRI can be used for more detailed examinations and can be of assistance in the differential diagnostic process.
Performance
Improved imaging of anatomical structures and of the composition of different tissues by the use of different MRI sequences.
Achievements
Fetal MRI has become a part of clinical routine in thoracic and abdominal malformations and is the basis for scientific research in this field.
Practical recommendations
In cases of thoracic or abdominal malformations fetal MRI provides important information additional to ultrasound to improve diagnostic accuracy, prognostic evaluation and surgical planning.
Literatur
Al-Assiri A, Wiseman N, Bunge M (2005) Prenatal diagnosis of intrathoracic stomach (gastric herniation). J Pediatr Surg 40:E15–E17
Applegate KE, Goske MJ, Pierce G et al (1999) Situs revisited: imaging of the heterotaxy syndrome. Radiographics 19:837–852 (discussion 853–834)
Bahado-Singh R, Oz U, Mari G et al (1998) Fetal splenic size in anemia due to Rh-alloimmunization. Obstet Gynecol 92:828–832
Berrocal T, Madrid C, Novo S et al (2004) Congenital anomalies of the tracheobronchial tree, lung, and mediastinum: embryology, radiology, and pathology. Radiographics 24:e17
Brewerton LJ, Chari RS, Liang Y et al (2005) Fetal lung-to-liver signal intensity ratio at MR imaging: development of a normal scale and possible role in predicting pulmonary hypoplasia in utero. Radiology 235:1005–1010
Cannie M, Jani J, Chaffiotte C et al (2008) Quantification of intrathoracic liver herniation by magnetic resonance imaging and prediction of postnatal survival in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 32:627–632
Cassart M, Massez A, Metens T et al (2004) Complementary role of MRI after sonography in assessing bilateral urinary tract anomalies in the fetus. Am J Roentgenol 182:689–695
Cavoretto P, Molina F, Poggi S et al (2008) Prenatal diagnosis and outcome of echogenic fetal lung lesions. Ultrasound Obstet Gynecol 32:769–783
Chaoui R, Zodan-Marin T, Wisser J (2002) Marked splenomegaly in fetal cytomegalovirus infection: detection supported by three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol 20:299–302
Faintuch J, Machado MC, Raia AA (1980) Suprahepatic gallbladder with hypoplasia of the right lobe of the liver. Arch Surg 115:658–659
Goto S, Suzumori N, Obayashi S et al (2012) Prenatal findings of omphalocele-exstrophy of the bladder-imperforate anus-spinal defects (OEIS) complex. Congenit Anom (Kyoto) 52:179–181
Granata C, Dell’acqua A, Lituania M et al (2003) Gastric duplication cyst: appearance on prenatal US and MRI. Pediatr Radiol 33:148–149
Green GE (2005) Magnetic resonance imaging of fetal thoracic abnormalities. Appl Radiol 34:68–74
Hamada H, Takano K, Shiina H et al (1999) New ultrasonographic criterion for the prenatal diagnosis of cloacal exstrophy: elephant trunk-like image. J Urol 162:2123–2124
Hormann M, Brugger PC, Balassy C et al (2006) Fetal MRI of the urinary system. Eur J Radiol 57:303–311
Kasprian G, Balassy C, Brugger PC et al (2006) MRI of normal and pathological fetal lung development. Eur J Radiol 57:261–270
Kul S, Korkmaz HA, Cansu A et al (2012) Contribution of MRI to ultrasound in the diagnosis of fetal anomalies. J Magn Reson Imaging 35:882–890
Lee SY, Chari RS, Bhargava R (2006) Fetal MRI in the evaluation of chest anomalies: a pictorial essay. Univ Alberta Health Sci J 3:27–30
Martin C, Darnell A, Escofet C et al (2012) Fetal MR in the evaluation of pulmonary and digestive system pathology. Insights Imaging 3:277–293
Okamoto T, Takamizawa S, Yokoi A et al (2008) Completely isolated alimentary tract duplication in a neonate. Pediatr Surg Int 24:1145–1147
Prayer D (Hrsg) (2011) Fetal MRI. Springer, Berlin Heidelberg New York
Ribet ME, Copin MC, Gosselin B (1995) Bronchogenic cysts of the mediastinum. J Thorac Cardiovasc Surg 109:1003–1010
Saguintaah M, Couture A, Veyrac C et al (2002) MRI of the fetal gastrointestinal tract. Pediatr Radiol 32:395–404
Sandrasegaran K, Lall C, Aisen AA et al (2005) Fast fetal magnetic resonance imaging. J Comput Assist Tomogr 29:487–498
Savelli S, Di Maurizio M, Perrone A et al (2007) MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) assessment in the evaluation of normal and abnormal fetal kidneys: preliminary experience. Prenat Diagn 27:1104–1111
Shinmoto H, Kashima K, Yuasa Y et al (2000) MR imaging of non-CNS fetal abnormalities: a pictorial essay. Radiographics 20:1227–1243
Simonovsky V, Lisy J (2007) Meconium pseudocyst secondary to ileal atresia complicated by volvulus: antenatal MR demonstration. Pediatr Radiol 37:305–309
Smrcek JM, Baschat AA, Germer U et al (2001) Fetal hydrops and hepatosplenomegaly in the second half of pregnancy: a sign of myeloproliferative disorder in fetuses with trisomy 21. Ultrasound Obstet Gynecol 17:403–409
Veyrac C, Couture A, Saguintaah M et al (2004) MRI of fetal GI tract abnormalities. Abdom Imaging 29:411–420
Wong AM, Toh CH, Lien R et al (2006) Prenatal MR imaging of a meconium pseudocyst extending to the right subphrenic space with right lung compression. Pediatr Radiol 36:1208–1211
Interessenkonflikt
Die korrespondierende Autorin gibt für sich und ihre Koautoren an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Woitek, R., Brugger, P., Asenbaum, U. et al. Fetale Magnetresonanztomographie thorakaler und abdomineller Malformationen. Radiologe 53, 123–129 (2013). https://doi.org/10.1007/s00117-012-2400-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00117-012-2400-6