Situs anomalies on prenatal MRI

Abstract Objective Situs anomalies refer to an abnormal organ arrangement, which may be associated with severe errors of development. Due regard being given to prenatal magnetic resonance imaging (MRI) as an adjunct to ultrasonography (US), this study sought to demonstrate the in utero visualization...

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Bibliographic Details
Published in:European journal of radiology 2012-04, Vol.81 (4), p.e495-e501
Main Authors: Nemec, Stefan F, Brugger, Peter C, Nemec, Ursula, Bettelheim, Dieter, Kasprian, Gregor, Amann, Gabriele, Rimoin, David L, Graham, John M, Prayer, Daniela
Format: Article
Language:English
Subjects:
Associated congenital malformations
Female
Heterotaxy Syndrome - diagnostic imaging
Heterotaxy Syndrome - pathology
Heterotaxy syndromes
Humans
Magnetic Resonance Imaging - methods
Male
Prenatal Diagnosis - methods
Prenatal MRI
Radiology
Reproducibility of Results
Sensitivity and Specificity
Situs anomalies
Ultrasonography - methods
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Summary:Abstract Objective Situs anomalies refer to an abnormal organ arrangement, which may be associated with severe errors of development. Due regard being given to prenatal magnetic resonance imaging (MRI) as an adjunct to ultrasonography (US), this study sought to demonstrate the in utero visualization of situs anomalies on MRI, compared to US. Materials and methods This retrospective study included 12 fetuses with situs anomalies depicted on fetal MRI using prenatal US as a comparison modality. With an MRI standard protocol, the whole fetus was assessed for anomalies, with regard to the position and morphology of the following structures: heart; venous drainage and aorta; stomach and intestines; liver and gallbladder; and the presence and number of spleens. Results Situs inversus totalis was found in 3/12 fetuses; situs inversus with levocardia in 1/12 fetuses; situs inversus abdominis in 2/12 fetuses; situs ambiguous with polysplenia in 3/12 fetuses, and with asplenia in 2/12 fetuses; and isolated dextrocardia in 1/12 fetuses. Congenital heart defects (CHDs), vascular anomalies, and intestinal malrotations were the most frequent associated malformations. In 5/12 cases, the US and MRI diagnoses were concordant. Compared to US, in 7/12 cases, additional MRI findings specified the situs anomaly, but CHDs were only partially visualized in six cases. Conclusions Our initial MRI results demonstrate the visualization of situs anomalies and associated malformations in utero , which may provide important information for perinatal management. Using a standard protocol, MRI may identify additional findings, compared to US, which confirm and specify the situs anomaly, but, with limited MRI visualization of fetal CHDs.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2011.06.016