Fetal gastrointestinal MRI: all that glitters in T1 is not necessarily colon

Colombani, Marina; Ferry, M.; Garel, Catherine; Cassart, Marie; Couture, A.; Guibaud, Laurent; Avni, Fred E.; Gorincour, Guillaume

doi:10.1007/s00247-009-1497-x

Cited by 23 publications

(9 citation statements)

References 18 publications

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“…Our data support previously reported studies that the MRI signal of dilated loops is helpful in better localizing the level of obstruction. Regarding the dilated bowel proximal to the obstruction, high T2 signal in the dilated bowel was mainly observed in cases of proximal obstruction, as previously suggested by the Colombani et al [17] and Furey et al [18] series. Rubio et al's [2] series described low T1 signal to describe proximal jejunal atresia, and the studies by Saguintaah et al [19] and Shinmoto et al [20] have suggested that the higher the signal on T1-weighted images, the more distal the atresia.…”

Section: Discussionsupporting

confidence: 75%

“…In addition, despite the long study period, the size of our study population remains small, and the exact impact of preterm delivery could not be appropriately taken into account. The absence of any diagnosis of cystic fibrosis in our se-ries might be surprising to some readers, given that it is a relatively frequent and well-known cause of prenatal bowel obstruction [2,17]. However, in our center, most cases were diagnosed by early genetic testing prior to MRI examinations, and many parents subsequently chose to terminate the pregnancy, in accordance with French law.…”

Section: Discussionmentioning

confidence: 82%

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Ultrasound and Fetal MRI Complementary Contributions to Appropriate Counseling in Small Bowel Obstruction

et al. 2021

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Objective: Bowel obstructions beyond the duodenum represent a heterogeneous group of congenital anomalies with a highly variable prognosis, the main issue being postnatal short bowel syndrome (SBS). The objective of our study was to evaluate the contributions of fetal MRI in cases of bowel obstruction. Materials and Methods: A retrospective analysis of all newborns, for whom both ante-natal ultrasound and fetal MRI were available, referred to our center for suspected bowel obstruction was performed. Examinations were reviewed blinded to the postnatal outcome. Key outcome measures included exact diagnosis and the existence of postoperative SBS. We evaluated the contribution of MRI in determining precise location and etiology of the bowel obstruction, dilatation of the proximal bowel loops, and assessment of the quality of the remaining distal bowel loops. Results: Twenty-five newborns were included. There were 19 single obstructions and 6 complex forms (4 apple peel syndromes and 2 multiple atresias). MRI correctly identified the affected segment of the small bowel in 59.1% of the cases. MRI identified the mechanism of obstruction in 72% of cases. MRI reliably predicted an abnormal appearance of the bowel distal to the obstruction in 100% of the severe cases (3/3) and in 66.7% of complex forms (4/6). Conclusion: Our study suggests that fetal MRI, when done in addition to prenatal ultrasound, is contributory in the management of fetuses with suspected bowel obstruction. MRI may be particularly useful in determining the location and origin of the bowel obstruction and in assessing the quality of the bowel distal to the obstruction, which might assist in the prediction of SBS and more detailed prenatal counseling.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 82%

Ultrasound and Fetal MRI Complementary Contributions to Appropriate Counseling in Small Bowel Obstruction

et al. 2021

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“…The false‐positive rate of detecting ND‐SBA by ultrasound is another relevant issue. The positive predictive value of prenatal ultrasound has been reported to be variable, ranging between 3% and 90%. Although the current systematic review was not designed specifically to investigate false‐positive rate, two studies reported the false‐positive rate of detecting ND‐SBA by ultrasound and provided an overall positive predictive value of 47.1% (95% CI, 23.0–72.2%).…”

Section: Discussionmentioning

confidence: 90%

Accuracy of prenatal ultrasound in detecting jejunal and ileal atresia: systematic review and meta‐analysis

Virgone

D’Antonio

Khalil

et al. 2015

Ultrasound in Obstet & Gyne

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“…2 In recent years, there is increasing evidence on the diagnostic potential of fetal magnetic resonance imaging (MRI) for fetal intestinal abnormalities. [1][2][3][4][5][6][7][8] The use of single-short fast spin-echo T2-weighted sequences for the evaluation of the expected location and morphology of fluid-containing structures, including the stomach and small bowel, and T1-weighted imaging for signal intensity characteristics of the fetal meconium, the normal pattern of the meconium with advancing gestation age, and the expected caliber of the small and large bowel in the fetus are key to the diagnoses of abnormalities of the gastrointestinal tract. 3 However, there are few large series on prenatally diagnosed fetal intestinal obstruction by MRI, especially combined with the operation results.…”

Section: Introductionmentioning

confidence: 99%

Appearance of fetal intestinal obstruction on fetal MRI

Zhao

et al. 2020

Prenatal Diagnosis

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Objective: To retrospectively analyze the imaging findings of fetal intestinal obstruction diagnosed by MRI and compare with postnatal surgery findings. Methods: MRI data of 3346 pregnant women were retrospectively analyzed; we found 47 cases of suspected fetal small intestinal obstruction. Twenty-nine underwent postnatal surgery. Results: We identified one case of jejunal obstruction secondary to perforation, five annular pancreas, 10 duodenal stenoses, four jejunal stenoses, five jejunal atresias, two ileal atresias, four intestinal volvulus, and four intestinal malrotations. We further found four cases of duodenal stenosis with intestinal malrotation (two cases also showed volvulus). On fetal MRI, annular pancreas and duodenal obstruction manifested as a "double bubble." Jejunal stenosis appeared as a "triple bubble." Jejunal and ileal atresia mainly manifested as proximal dilatation with high signal on T1WI. Intestinal volvulus showed a sausage-like intestinal distortion and mixed signals on T1WI and DWI sequences. Intestinal malrotations were characterized as abnormal duodenal morphology. We missed two malrotations; one jejunal obstruction was misdiagnosed. Conclusion: Prenatal MRI can accurately determine the degree of intestinal obstruction and help qualitatively diagnose its possible etiology according to changes in MRI signals in multiple sequences, providing guidance for prenatal counseling.

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Fetal gastrointestinal MRI: all that glitters in T1 is not necessarily colon

Abstract: In cases of fetal occlusion, T1 hypersignal should not be considered as a sign of distal ileal or colonic occlusion. The obstruction may be proximal, implying a risk of small bowel syndrome, which requires adequate parental counselling.

Cited by 23 publications

References 18 publications

Ultrasound and Fetal MRI Complementary Contributions to Appropriate Counseling in Small Bowel Obstruction

Ultrasound and Fetal MRI Complementary Contributions to Appropriate Counseling in Small Bowel Obstruction

Accuracy of prenatal ultrasound in detecting jejunal and ileal atresia: systematic review and meta‐analysis

Appearance of fetal intestinal obstruction on fetal MRI

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