Intracranial magnetic resonance imaging findings in the surviving fetus after spontaneous monochorionic cotwin demise

Jelin, Angie C.; Norton, Mary E.; Bartha, Agnes I.; Fick, Andrea; Glenn, Orit A.

doi:10.1016/j.ajog.2008.06.062

Cited by 62 publications

(48 citation statements)

References 18 publications

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“…A recent study has shown that a third of the surviving twins had abnormal findings on in-utero cerebral MR imaging, mostly undiagnosed by prenatal sonography. 7 However, both prenatal sonography and conventional T2 MR imaging might fail to detect brain lesions in the first 2 weeks after the death of the co-twin. In the event of a cerebral ischemic lesion, diffusion of water molecules within the tissue is hindered by the swelling of cells and restriction of extracellular space, which are associated with the development of cytotoxic edema.…”

mentioning

confidence: 99%

Diffusion MRI Findings in Monochorionic Twin Pregnancies after Intrauterine Fetal Death

Hoffmann

Weisz

Yinon³

et al. 2012

AJNR Am J Neuroradiol

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confidence: 99%

Diffusion MRI Findings in Monochorionic Twin Pregnancies after Intrauterine Fetal Death

Hoffmann

Weisz

Yinon³

et al. 2012

AJNR Am J Neuroradiol

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“…Another serious complication of monochorionic twin pregnancies is twintwin transfusion syndrome. The morbidity rate in this syndrome is high, and both the donor and the recipient twin are at increased risk for cerebral ischemia and hemorrhage (47). Brain abnormalities detected by fetal MRI are similar to those seen in survivors of co-twin demise (Fig.…”

Section: Complications Of Monochorionic Twin Pregnanciesmentioning

confidence: 55%

“…Sonographically, occult abnormalities can be detected in one-third of surviving twins, with abnormalities including polymicrogyria, encephalomalacia, germinolytic cysts, hemorrhage, ventriculomegaly, and delayed sulcation (47,48). Another serious complication of monochorionic twin pregnancies is twintwin transfusion syndrome.…”

Section: Complications Of Monochorionic Twin Pregnanciesmentioning

confidence: 99%

A peek into the uterus – MRI of the fetal CNS

Vesnaver

2016

Pedaiatr Today

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The purpose of this article is to provide an overview of MR imaging of the fetal central nervous system, and to briefly discuss recent advances. Fetal MRI has been commonly used throughout the world for over 20 years. Compared to US it has better contrast resolution, allows direct visualization of both hemispheres and the additional limitations of sonography do not affect the quality of MRI. There are no known adverse short-term or long-term side effects of MRI in children, who were imaged in the fetal period. The standard protocol for fetal MRI consists of single-shot rapid acquisition T2 weighted sequences in three planes, fast spoiled gradient recalled T1 weighted sequence, T2 gradient echo sequence and diffusion weighted sequence in the axial plane. The clinical applications of advanced MRI techniques are still limited. Fetal MRI is performed to confirm abnormalities detected on US, and to exclude additional pathology. Interpreting fetal MRI images requires understanding of normal fetal CNS development and one should also evaluate other fetal structures, the umbilical cord and placenta. The most common indication for MR imaging of the fetal CNS is mild ventriculomegaly. Other common indications, that are also discussed in the article, include commissural abnormalities, infratentorial abnormalities, cortical malformations, spinal pathology and complications of monochorionic twin pregnancy. ConclusionFetal MRI provides important information in prenatal counseling, therefore familiarity with the applications and limitations of fetal MRI, and multidisciplinary collaboration remain essential for the radiologist involved in prenatal imaging.

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“…Previous studies analyzing fetal MRI of the survivor in monochorionic twin pregnancies after sFD reported lower rates of cerebral lesions at fetal MRI compared to our results. Beside a few case reports (Glenn et al, 2005;Righini et al, 2004;2007), Jelin et al (2008) reported a rate of 33% of intracranial abnormalities in 21 monochorionic twin pregnancies with spontaneous sFD; they reported no neurologic outcome. Hoffmann et al (2013) reported a rate of 24% of abnormal prenatal cerebral findings at fetal MRI in 34 monochorionic twin pregnancies with sFD, including spontaneous sFD as well as sFD after intervention.…”

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Cerebral Lesions at Fetal Magnetic Resonance Imaging and Neurologic Outcome After Single Fetal Death in Monochorionic Twins

et al. 2015

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Background: Single fetal death (sFD) in monochorionic twin pregnancies is associated with substantial morbidity and mortality in the survivor. The aim of our study was to evaluate the rate of cerebral lesions detected at fetal Magnetic Resonance Imaging (MRI) and to correlate the results with the neurologic outcome of the survivors of monochorionic twin pregnancies after sFD. Methods: Between 2005 and 2012, 11 monochorionic twin pregnancies with sFD and subsequent fetal MRI of the survivor were included. All neonates underwent neurologic assessment after birth and 56% of surviving infants underwent long-term neurologic assessment. MRI findings and neurologic outcome of the survivors were evaluated. Results: Gestational age at sFD was 20.9 (±2.9) weeks; 55% (6/11) of survivors of monochorionic twin pregnancies after sFD showed cerebral lesions at fetal MRI; 72% (8/11) of all survivors had normal neonatal neurologic outcome: all survivors with normal fetal MRI and 50% of survivors with cerebral lesions at fetal MRI. Longterm neurologic assessment was normal in all tested patients with normal fetal MRI and in one of three tested patients with cerebral lesions at fetal MRI. Conclusion: Survivors of monochorionic twin pregnancies after sFD show a high rate of cerebral lesions at fetal MRI. The importance of cerebral lesions at fetal MRI in survivors after sFD in monochorionic twin pregnancies is uncertain. All tested survivors with normal fetal MRI showed normal neurologic outcome but only one of three survivors with cerebral lesions at fetal MRI showed normal long-term neurologic outcome.

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Intracranial magnetic resonance imaging findings in the surviving fetus after spontaneous monochorionic cotwin demise

Cited by 62 publications

References 18 publications

Diffusion MRI Findings in Monochorionic Twin Pregnancies after Intrauterine Fetal Death

Diffusion MRI Findings in Monochorionic Twin Pregnancies after Intrauterine Fetal Death

A peek into the uterus – MRI of the fetal CNS

Cerebral Lesions at Fetal Magnetic Resonance Imaging and Neurologic Outcome After Single Fetal Death in Monochorionic Twins

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