Evaluation of the fetal abdomen by magnetic resonance imaging. Part 2: abdominal wall defects and tumors

Abstract

Although ultrasound is still the gold standard for the assessment of fetal malformations, magnetic resonance imaging (MRI) has gained great prominence in recent years. In situations in which ultrasound has low sensitivity, such as maternal obesity, abdominal scarring, and oligohydramnios, MRI has proven to be a safe and accurate method. Regarding fetal abdominal wall defects, MRI appears to be widely used in the prognostic assessment of gastroschisis with intestinal atresia or of complications of omphalocele, allowing better perinatal management and parental counseling. In addition, MRI allows the assessment of local invasion of fetal abdominal tumors, with significant prognostic value for the postnatal period. In this article, we review the main MRI findings in the evaluation of fetal abdominal wall defects and tumors.

Embriologia da Parede Abominal Aplicada aos Defeitos da Parede Abdominal : Aspectos Translacionais

“…A ressonância nuclear magnética (RNM) pode também ser utilizada para avaliação das malformações da parede abdominal fetal. A RNM é utilizada na avaliação prognóstica de atresia intestinal, gastrosquise e complicações da onfalocele, permitindo um melhor manejo perinatal (42). A RNM permite visualizar na onfalocele o defeito da parede abdominal, as vísceras herniadas e uma cápsula fina que envolve seu conteúdo e os separa do líquido amniótico.…”

Prenatal ultrasound diagnosis of anterior abdominal wall defects in sub Saharan Africa; simple but often missed

“…MRI has been found to offer better resolution in the presence of oligohydramnios. 13 Other non-radiologic investigation that can help in increasing the strength of diagnosis in suspected case of anterior abdominal wall defect is elevated maternal serum alpha fetoprotein (MSAFP). High levels of MSAFP in a pregnant woman is an indication for ultrasonic evaluation of the fetal ventral wall.…”

Is fetal magnetic resonance imaging volumetry of eventrated organs in gastroschisis predictive for surgical treatment?

“…Because of its widespread availability, sonography is regarded as the modality of choice for prenatal imaging of gastroschisis. Owing to excellent tissue contrast and wide field of view, fetal MRI is increasingly used in congenital malformations including abdominal pathologies [ 12 ]. Prognostic factors associated with poor outcome in gastroschisis are intestinal atresia, volvulus or perforation, which might be detected by prenatal imaging [ 13 ].…”

“…To date, similar parameters have not been investigated in fetal MRI, according to the literature. Recent studies regarding MRI in gastroschisis report morphological and descriptive characteristics for diagnosis and fetal development, but no standardized parameters regarding prediction of treatment or outcome [ 12 , 13 , 15 , 16 ]. This study assessed fetal-MRI-based volumetry in fetuses with gastroschisis and evaluated its possible predictive value regarding surgical treatment.…”