Fetal Central Nervous System Anomalies Detected by Magnetic Resonance Imaging: A Two-Year Experience

Abstract

BackgroundMagnetic resonance imaging (MRI) is gradually becoming more common for thorough visualization of the fetus than ultrasound (US), especially for neurological anomalies, which are the most common indications for fetal MRI and are a matter of concern for both families and society.ObjectivesWe investigated fetal MRIs carried out in our center for frequency of central nervous system anomalies. This is the first such report in southern Iran.Materials and MethodsOne hundred and seven (107) pregnant women with suspicious fetal anomalies in prenatal ultrasound entered a cross-sectional retrospective study from 2011 to 2013. A 1.5 T Siemens Avanto scanner was employed for sequences, including T2 HASTE and Trufisp images in axial, coronal, and sagittal planes to mother’s body, T2 HASTE and Trufisp relative to the specific fetal body part being evaluated, and T1 flash images in at least one plane based on clinical indication. We investigated any abnormality in the central nervous system and performed descriptive analysis to achieve index of frequency.ResultsMean gestational age ± standard deviation (SD) for fetuses was 25.54 ± 5.22 weeks, and mean maternal age ± SD was 28.38 ± 5.80 years Eighty out of 107 (74.7%) patients who were referred with initial impression of borderline ventriculomegaly. A total of 18 out of 107 (16.82%) patients were found to have fetuses with CNS anomalies and the remainder were neurologically normal. Detected anomalies were as follow: 3 (16.6%) fetuses each had the Dandy-Walker variant and Arnold-Chiari II (with myelomeningocele). Complete agenesis of corpus callosum, partial agenesis of corpus callosum, and aqueductal stenosis were each seen in 2 (11.1%) fetuses. Arnold-Chiari II without myelomeningocele, anterior spina bifida associated with neurenteric cyst, arachnoid cyst, lissencephaly, and isolated enlarged cisterna magna each presented in one (5.5%) fetus. One fetus had concomitant schizencephaly and complete agenesis of the corpus callosum.ConclusionsMRI is superior to ultrasound and physical exam of live births in detection of CNS anomalies. In this investigation within a single referral center in southern Iran, anomalies included Dandy-Walker variant and Arnold-Chiari II as the most common findings. Other findings with lower incidence were complete and partial agenesis of corpus callosum, aqueductal stenosis, anterior spina bifida, schizencephaly, arachnoid cyst, lissencephaly, and isolated enlarged cisterna magna.

Congenital Aqueductal Stenosis: Findings at Fetal MRI That Accurately Predict a Postnatal Diagnosis

“…10 Fetal MR imaging has become a major problem-solving tool in the evaluation of ventriculomegaly based on its ability to define the underlying etiology as well as any associated abnormalities. 17 The etiology of CAS is multifactorial, including both genetic and acquired forms. 7 Acquired causes can be intrinsic (obstruction of the aqueduct lumen) or extrinsic (external compression).…”

Ultrasound and magnetic resonance imaging in the prenatal diagnosis of open spina bifida

“…MRI allows a more accurate prenatal diagnosis than US, due to the detailed description of the cerebellum and the posterior fossa and can give a full assessment of the spinal lesion or other complications in Chiari II malformation (fig 4a) [42,[46][47][48][49].…”

Spina Bifida: Morphological Features, Molecular Regulations and Signal Pathways

“…In progressive ages with spina bifida occulta 13.7% of the patients have problem with the overactive bladder [44]. Anterior spina bifida more rare than posterior and fetuses can be diagnosed with magnetic resonance imaging [45]. In elder ages anterior meningocele of sacrum projected into the retro-peritoneum of pre-sacral space is reported during pregnancy.…”