Fetal suprarenal masses – assessing the complementary role of magnetic resonance and ultrasound for diagnosis

Abstract

US and MRI both accurately detect suprarenal masses. MRI complements US in equivocal diagnoses and detects additional findings such as liver metastases in neuroblastoma.

Diagnosis of neonatal neuroblastoma with postmortem magnetic resonance imaging

“…The earliest documentation of prenatal diagnosis of neuroblastoma was in 1983 by Fenart et al when a 1.4-cm hyperechoic adrenal mass was identified, and then removed following birth [1] . Since then, many case reports of fetal neuroblastoma have been published; however, relatively few demonstrate metastatic disease [2] . Improvements in prenatal imaging and widespread use of fetal ultrasonography have led to an increased rate of prenatal diagnosis of fetal neuroblastoma.…”

Current controversies in prenatal diagnosis 3: Fetal MRI should be performed in all prenatally detected fetuses with a major structural abnormality

“…Subsequently, the radiographic, genetic, and obstetric literature have reported the expanded utility of MRI for evaluating anomalies of the fetal face, eyes, skin, heart, lungs, gastrointestinal, and genitourinarysystems . Adrenal masses are just 1 example of the added value of MRI's soft tissue resolution to improve diagnostic accuracy . Adrenal region masses include subdiaphragmatic sequestration, adrenal hemorrhage, neuroblastoma, and lymphatic malformations.…”

“…15 Adrenal masses are just 1 example of the added value of MRI's soft tissue resolution to improve diagnostic accuracy. 16 Adrenal region masses include subdiaphragmatic sequestration, adrenal hemorrhage, neuroblastoma, and lymphatic malformations. For neuroblastoma associated with liver metastases, correct diagnosis is critical for parental counseling, planning delivery location, and immediate postnatal management (Figure 4).…”

What is your diagnosis?

“…Color flow Doppler evaluation can show blood flow in a neuroblastoma, which is always absent in a hematoma (5). A combination of ultrasound and magnetic resonance imaging (MRI) gives more definitive information to allow correct diagnosis (8). Bilateral adrenal lesions are most likely adrenal hemorrhage because bilateral adrenal tumors are very rare.…”