Postmortem High-Resolution Fetal Magnetic Resonance Imaging in Three Cases of Lower Urinary Tract Obstruction

Lefere, Mathieu; Sandaite, Inga; Hindryckx, An; Devlieger, Roland; Catte, Luc De; Moerman, Philippe; Claus, Filip

doi:10.1159/000351030

Cited by 5 publications

(2 citation statements)

References 5 publications

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“…Bladder‐outlet obstruction is a rare anomaly and MRI is usually not part of its prenatal care. However, its diagnostic potential is currently being explored 12,13 . Compared with two‐dimensional sequences, 3D‐MRI acquisitions may prove valuable in LUTO when determining the cause of the obstruction, since this allows visualization of every plane of the lower urinary tract.…”

Section: Discussionmentioning

confidence: 99%

Biometric and morphological features on magnetic resonance imaging of fetal bladder in lower urinary tract obstruction: new perspectives for fetal cystoscopy

Vinit

Grévent

Millischer

et al. 2020

Ultrasound in Obstet & Gyne

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Objectives Incompatibility between currently available fetoscopes and the anatomical constraints of the distended fetal bladder, with the resulting curvature around the bladder neck, account for most technical difficulties during fetal cystoscopy in lower urinary tract obstruction (LUTO). The aim of this anatomical study was to assess by magnetic resonance imaging (MRI) the variation in three bladder angles (bladder‐neck angle (BNA), vesicourethral angle (VUA) and angle between bladder dome and posterior urethra (DUA)), according to gestational age (GA), bladder volume and the presence of LUTO. Methods From our fetal medicine database, we retrieved for review 46 MRI examinations of male fetuses between 2015 and 2019, including 17 with LUTO, examined at a mean GA of 28.1 (range, 17.3–35.0) weeks and 29 age‐matched controls, examined at 29.9 (range, 21.9–35.0) weeks. We measured bladder volume, bladder‐wall thickness and the three bladder angles, and used the Mann–Whitney U‐test to compare values between groups. Variations according to GA and bladder volume were determined using analysis of variance (ANOVA). A reliability study was performed using the Bland–Altman method and Lin's correlation coefficient was calculated. Results Both bladder volume and bladder‐wall thickness were significantly greater in the LUTO group (P < 0.01). BNA was significantly larger in LUTO compared with control fetuses: the mean (range) was 127.1° (101.6–161.6°) vs 111.2° (88.5–157.3°) (P < 0.01). DUA averaged 117° and showed no difference between the groups (P = 0.92). No statistical comparison was performed on VUA since this was not measurable in most control fetuses. ANOVA showed no variation of any angle with bladder volume in both LUTO fetuses and control fetuses. BNA in LUTO fetuses was the only angle to vary with GA, being larger after, compared with at or before, 25 weeks (P = 0.04). The reliability study showed an acceptable bias for both intra‐ and interobserver reproducibility for all three angles. Conclusion The findings that BNA is increased by approximately 15° in fetuses with LUTO and DUA averages 117° could aid in development of a customized fetal cystoscope and help to overcome the current technical challenges of fetal cystoscopy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Discussionmentioning

confidence: 99%

Biometric and morphological features on magnetic resonance imaging of fetal bladder in lower urinary tract obstruction: new perspectives for fetal cystoscopy

Vinit

Grévent

Millischer

et al. 2020

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

show abstract

“…[ 5 , 8 , 9 ]. A persistent cloaca generally presents with an enlarged bladder prior to 16 weeks gestation, and will often accompany presence of debris within the cloaca, and intraluminal calcifications within bowel loops (due to intestinal communication) [ 2 , 10 – 13 ]. Caudal regression generally presents with normal amniotic fluid volume, vertebral and lower extremity defects, and bladder extrophy.…”

Section: Introductionmentioning

confidence: 99%

Fetal Lower Urinary Tract Obstruction (LUTO): a practical review for providers

Haeri¹

2015

matern health, neonatol and perinatol

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Fetal lower urinary tract obstruction (LUTO) is a serious condition, which commonly results in marked perinatal morbidity and mortality. The characteristic prenatal presentation of LUTO includes an enlarged bladder with bilateral obstructive uropathy. While mild forms of the disease result in minimal clinical sequelae, the more severe forms commonly lead to oligohydramnios, dysplastic changes in the fetal kidneys, and ultimately result in secondary pulmonary hypoplasia. The aim of this review is to provide practitioners with a practical and concise overview of the presentation, evaluation, and treatment of LUTO.

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Current applications of in utero intervention for lower urinary tract obstruction

Smith‐Harrison

Hougen²,

Timberlake³

et al. 2015

Journal of Pediatric Urology

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Postmortem High-Resolution Fetal Magnetic Resonance Imaging in Three Cases of Lower Urinary Tract Obstruction

Cited by 5 publications

References 5 publications

Biometric and morphological features on magnetic resonance imaging of fetal bladder in lower urinary tract obstruction: new perspectives for fetal cystoscopy

Biometric and morphological features on magnetic resonance imaging of fetal bladder in lower urinary tract obstruction: new perspectives for fetal cystoscopy

Fetal Lower Urinary Tract Obstruction (LUTO): a practical review for providers

Current applications of in utero intervention for lower urinary tract obstruction

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