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Pictorial essay: MRI of the fetal brain.

B GR, Ramamurthy B - Indian J Radiol Imaging (2009)

Bottom Line: Subtle or inconclusive USG abnormalities can be confirmed or ruled out by MRI.There have been no reports of deleterious effects of MRI on the fetus.A few case examples are presented to illustrate the advantages of MRI.

View Article: PubMed Central - PubMed

ABSTRACT
MRI is a useful supplement to USG for the assessment of fetal brain malformations. Superior soft tissue contrast and the ability to depict sulcation and myelination are the strengths of MRI. Subtle or inconclusive USG abnormalities can be confirmed or ruled out by MRI. In some cases, additional findings detected with MRI often help in arriving at a definitive diagnosis, which is necessary for parental counseling and for guiding management. Fast T2W sequences form the basis of fetal MRI. There have been no reports of deleterious effects of MRI on the fetus. A few case examples are presented to illustrate the advantages of MRI.

No MeSH data available.


Related in: MedlinePlus

Single live gestation at 37 weeks. USG scans of the heart (A) and brain (B) show a cardiac rhabdomyoma (arrow in A) and mild ventriculomegaly (arrow in B). Axial (C) and coronal (D) T2W MRI images show subependymal tubers (arrowheads), confirming the diagnosis of tuberous sclerosis. The large left lateral ventricular subependymal nodule at the foramen of Monroe is probably responsible for the unilateral ventriculomegaly. The infant developed ash-leaf macules at 1 month and myoclonic jerks at 2 months of age. It died at 3 months (cradle death)
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Figure 0004: Single live gestation at 37 weeks. USG scans of the heart (A) and brain (B) show a cardiac rhabdomyoma (arrow in A) and mild ventriculomegaly (arrow in B). Axial (C) and coronal (D) T2W MRI images show subependymal tubers (arrowheads), confirming the diagnosis of tuberous sclerosis. The large left lateral ventricular subependymal nodule at the foramen of Monroe is probably responsible for the unilateral ventriculomegaly. The infant developed ash-leaf macules at 1 month and myoclonic jerks at 2 months of age. It died at 3 months (cradle death)

Mentions: Marginal ventriculomegaly is one such instance. MRI may detect the presence of heterotopia or sulcational disorders, which have profound prognostic and counseling implications. In the case illustrated in Figure 4, the presence of fetal cardiac rhabdomyoma and unilateral marginal ventriculomegaly prompted the MRI examination. Multiple subependymal tubers were demonstrated on MRI, thus clinching the diagnosis of tuberous sclerosis. Bilateral ventriculomegaly, especially of the occipital horns, was the indication for MRI in the case illustrated in Figure 5. Here, MRI clearly demonstrates bilateral, symmetric, neuroparenchymal loss in the parieto-occipital watershed regions as against the USG possibility of clefting; these findings suggest an ischemic etiopathogenesis rather than a neuronal migrational disorder such as schizencephaly. MRI demonstrated the extent, location, symmetry, and morphology of the defects better than USG. In the case illustrated in Figure 6, USG detection of ventriculomegaly, periventricular calcification, cortical thinning, and cerebellar hypoplasia led to a referral for MRI. MRI confirmed the severity of cerebral and cerebellar atrophy but failed to demonstrate calcification. Congenital cytomegalovirus infection was then considered.


Pictorial essay: MRI of the fetal brain.

B GR, Ramamurthy B - Indian J Radiol Imaging (2009)

Single live gestation at 37 weeks. USG scans of the heart (A) and brain (B) show a cardiac rhabdomyoma (arrow in A) and mild ventriculomegaly (arrow in B). Axial (C) and coronal (D) T2W MRI images show subependymal tubers (arrowheads), confirming the diagnosis of tuberous sclerosis. The large left lateral ventricular subependymal nodule at the foramen of Monroe is probably responsible for the unilateral ventriculomegaly. The infant developed ash-leaf macules at 1 month and myoclonic jerks at 2 months of age. It died at 3 months (cradle death)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2747421&req=5

Figure 0004: Single live gestation at 37 weeks. USG scans of the heart (A) and brain (B) show a cardiac rhabdomyoma (arrow in A) and mild ventriculomegaly (arrow in B). Axial (C) and coronal (D) T2W MRI images show subependymal tubers (arrowheads), confirming the diagnosis of tuberous sclerosis. The large left lateral ventricular subependymal nodule at the foramen of Monroe is probably responsible for the unilateral ventriculomegaly. The infant developed ash-leaf macules at 1 month and myoclonic jerks at 2 months of age. It died at 3 months (cradle death)
Mentions: Marginal ventriculomegaly is one such instance. MRI may detect the presence of heterotopia or sulcational disorders, which have profound prognostic and counseling implications. In the case illustrated in Figure 4, the presence of fetal cardiac rhabdomyoma and unilateral marginal ventriculomegaly prompted the MRI examination. Multiple subependymal tubers were demonstrated on MRI, thus clinching the diagnosis of tuberous sclerosis. Bilateral ventriculomegaly, especially of the occipital horns, was the indication for MRI in the case illustrated in Figure 5. Here, MRI clearly demonstrates bilateral, symmetric, neuroparenchymal loss in the parieto-occipital watershed regions as against the USG possibility of clefting; these findings suggest an ischemic etiopathogenesis rather than a neuronal migrational disorder such as schizencephaly. MRI demonstrated the extent, location, symmetry, and morphology of the defects better than USG. In the case illustrated in Figure 6, USG detection of ventriculomegaly, periventricular calcification, cortical thinning, and cerebellar hypoplasia led to a referral for MRI. MRI confirmed the severity of cerebral and cerebellar atrophy but failed to demonstrate calcification. Congenital cytomegalovirus infection was then considered.

Bottom Line: Subtle or inconclusive USG abnormalities can be confirmed or ruled out by MRI.There have been no reports of deleterious effects of MRI on the fetus.A few case examples are presented to illustrate the advantages of MRI.

View Article: PubMed Central - PubMed

ABSTRACT
MRI is a useful supplement to USG for the assessment of fetal brain malformations. Superior soft tissue contrast and the ability to depict sulcation and myelination are the strengths of MRI. Subtle or inconclusive USG abnormalities can be confirmed or ruled out by MRI. In some cases, additional findings detected with MRI often help in arriving at a definitive diagnosis, which is necessary for parental counseling and for guiding management. Fast T2W sequences form the basis of fetal MRI. There have been no reports of deleterious effects of MRI on the fetus. A few case examples are presented to illustrate the advantages of MRI.

No MeSH data available.


Related in: MedlinePlus