Fetal curarization for prenatal magnetic resonance imaging

Daffos, F.; Forestier, F.; Aleese, J. Mac; Aufrant, C; Mandelbrot, Laurent; Ea, Cabanis; Iba-Zizen, M. T.; Alfonso, J. M. Alfonso; Tamraz, J.

doi:10.1002/pd.1970080412

Cited by 54 publications

(15 citation statements)

References 10 publications

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“…Consistent with earlier reports [16,18,20], the increased size of the brain and reduced fetal motion in the third trimester enhanced the use of MRI. Adequate sedation was achieved using intramuscular morphine sulfate, although several investigators have used intravenous diazepam [20] or fetal neuromuscular blockade with curare [4,6] or pancuronium bromide [16].…”

Section: Discussionmentioning

confidence: 99%

The use of magnetic resonance imaging for the diagnosis of fetal intracranial anomalies

1990

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While fetal cranial sonography has been used for the sensitive detection of ventriculomegaly, ancillary imaging techniques may be needed for precise delineation of structural abnormalities. This report outlines the radiologic and clinical results using maternal magnetic resonance imaging (MRI) in ten patients with suspected fetal intracranial anomalies. Imaging was accomplished at 17-39 weeks gestational age, using spin-echo, a multislice technique with intramuscular morphine sulfate for sedation. In four cases, MRI significantly clarified the sonographic diagnosis, while in two cases the scan agreed with the sonographic findings. In one patient, MRI failed to image a lumbar meningomyelocele associated with the Chiari II malformation. In two patients with the Chiari II malformation, both sonography and MRI failed to delineate the anatomic pathology completely. Optimal imaging resolution was achieved in the third trimester. Four patients died in the perinatal period. All the surviving patients required shunting to treat intracranial hypertension: only two patients were meeting cognitive milestones. We conclude that due to the high incidence of multiple anomalies in the fetus with ventriculomegaly, precision in neuroradiological diagnosis is essential. MRI can be a useful adjunct to cranial sonography for the specific delineation of abnormalities of the fetal central nervous system.

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Section: Discussionmentioning

confidence: 99%

The use of magnetic resonance imaging for the diagnosis of fetal intracranial anomalies

1990

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“…A phased-array surface coil should be used. Some authors suggest using a premedication to sedate the fetus thus reducing fetal movements [10,11]; however, we are convinced that premedication is not required any longer in the day and age of fast, single-shot MR imaging. In our experience, sedation has never been necessary to obtain optimal images.…”

Section: Technical Considerationsmentioning

confidence: 94%

Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities

Ertl‐Wagner¹,

Lienemann²,

Strauß³

et al. 2002

Eur Radiol

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Fetal MR imaging often poses a diagnostic challenge for the radiologist. Both fetal anatomy and pathology differ decidedly from pediatric and adult MR imaging. While ultrasound remains the method of choice for screening examinations of the fetus, MR imaging is playing an increasingly important role in the detection and classification of malformations not diagnosable by ultrasonography alone. Recently, advances in fast single-shot MR sequences have allowed high-resolution, high-quality imaging of the moving fetus. Preferable sequences to be applied are a true fast imaging steady precession (true-FISP) or a half-Fourier acquired single-shot turbo spin-echo (HASTE) sequence. Premedication is generally no longer required. In all fetal MR imaging, every aspect of fetal anatomy has to be scrutinized. Subsequently, any abnormalities need to be described and classified. A close collaboration with the referring obstetrician is of paramount importance.

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“…Until recently, the long acquisition times required for this investigation were not conductive to foetal imaging because foetal movements resulted in poor quality images. Obtaining adequate images with the traditional spin-echo technniques required foetal sedation or paralysis (Daffos et al, 1988). Within the development of ultrafast scanning techniques, the artifacts caused by foetal motion have almost been eliminated (Hubbard et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Prenatal and Postnatal Diagnostics Problems of the Most Common Surgical Congenital Malformations of Newborns in Latvia

Ābola¹,

Pētersons²,

Pugacevska³

et al. 2009

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Prenatal and Postnatal Diagnostics Problems of the Most Common Surgical Congenital Malformations of Newborns in Latvia The most common surgical congenital malformations of newborns in Latvia are esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), duodenal atresia (DA) and abdominal wall defects — gastroschisis (G) and omphalocele (O). Survival and quality of life of these patients depend on precise pre- and postnatal diagnosis, timely and qualified treatment, and presence of associated anomalies and prematurity. The aim of our study was to define prenatal and postnatal diagnostic problems of the most common surgical congenital malformations of new-borns in Latvia. Data concerning pre- and postnatal diagnostics from case-records of patients treated in Children's Clinical University Hospital from 1998 till 2008 with esophageal atresia (58 patients), duodenal atresia (20 patients) and congenital abdominal wall defects — gastroschisis (17 patients) and omphalocele (28 patients) were analysed. Results showed that in case of EA prenatal USG was performed in 62% of expectant mothers and in neither case suspicion about. EA was expressed. In all patients after birth diagnostic placement of nasogastric tube was performed. In approximately one-third catheter of bad opaqueness was used. Preoperative bronchoscopy and esophagoscopy in order to exclude upper tracheoesophageal fistula were performed in two patients from the analysed group. In 40% of cases DA was diagnosed in prenatal ultrasonography. G was diagnosed prenatally in 29.4%, O — only in 3.7%.

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Fetal curarization for prenatal magnetic resonance imaging

Cited by 54 publications

References 10 publications

The use of magnetic resonance imaging for the diagnosis of fetal intracranial anomalies

The use of magnetic resonance imaging for the diagnosis of fetal intracranial anomalies

Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities

Prenatal and Postnatal Diagnostics Problems of the Most Common Surgical Congenital Malformations of Newborns in Latvia

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