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DOI: 10.1055/s-2006-927307
© Georg Thieme Verlag KG Stuttgart · New York
Fetales MRT
Fetal MRIPublication History
eingereicht: 10.8.2006
angenommen: 28.10.2006
Publication Date:
07 March 2008 (online)
![](https://www.thieme-connect.de/media/roefo/200702/lookinside/thumbnails/10.1055-s-2006-927307-1.jpg)
Zusammenfassung
Die Sonografie ist als pränatale Screeninguntersuchung Methode der ersten Wahl, aber nicht immer kann sie alle notwendigen Informationen liefern und eine MRT des Fetus kann zur Komplettierung oder Sicherung einer Verdachtsdiagnose indiziert sein. Die Zahl der fetalen MRT-Untersuchungen ist steigend. Initial wurde die MRT zur Evaluierung zerebraler Fehlbildungen eingesetzt. Die Untersuchung der fetalen Hirnreifung in vivo mit Migration, Gyrierung und Myelinisierung, wurde durch die MRT potenziert. Eine adäquate Analyse des fetalen Thorax und des Abdomens ist mit schnellen T2-, T1-gewichteten und Diffusionsgewichteten Sequenzen (DWI) möglich. Vorteile der MRT sind das große field of view und der hohe Weichteilkontrast. Dies erlaubt die sichere Diagnose von kongenitalen Zwerchfellhernien und eine Evaluation der Konsequenzen für das pulmonale Wachstum. Pulmonale Erkrankungen wie die zystisch adenomatoide Malformation, Sequestrationen oder bronchogene Zysten können differenziert und in ihrer Ausdehnung genau beschrieben werden. Mit der DWI können die Nieren in ihrer Lage schnell erfasst werden und die Diagnose einer Agenesie ist so in kürzester Zeit mit nur einer Sequenz möglich. Die pränatale MRT ist einer postnatalen (z. B. präoperativen) Untersuchung nahezu gleichwertig, erspart jedoch den zusätzlichen Transport und den Stress einer MRT des kranken Neugeborenen und bietet bei Malformationen mit OP-Indikation somit auch logistische Vorteile und verbessert das postnatale Management.
Abstract
Ultrasonography is the method of choice for prenatal malformation screening, but it does not always provide sufficient information for correct diagnosis or adequate abnormality evaluation. Fetal MRI is increasingly being used to complete sonographic findings. It was initially used for evaluation of cerebral abnormalities but is increasingly being applied to other fetal areas. In vivo investigation of fetal brain maturation has been enhanced by MRI. An adequate analysis of fetal chest and abdomen can be achieved with fast T2-, T1-weighted and diffusion-weighted imaging (DWI). The advantages include the great field of view and the excellent soft tissue contrast. This allows correct diagnosis of congenital diaphragmatic hernia and evaluation of the consequences on pulmonary growth. Other pulmonary malformations, such as cystic adenomatoid malformation, sequestration and bronchogenic cysts, can also be easily identified. Renal position can be quickly determined using DWI sequences and renal agenesia can be easily diagnosed with only one sequence. Prenatal MRI is virtually as effective as postnatal examination, dispenses with transport of a potentially very ill newborn, and provides logistic advantages. Therefore, prenatal MRI is useful for adequate postnatal treatment of newborns with malformations.
Key words
fetus - imaging sequences - ultrasound - obstetrics - MR imaging
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