Am J Perinatol 2014; 31(07): 567-576
DOI: 10.1055/s-0034-1371712
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Advances in Fetal Imaging

Erika Rubesova
1   Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California
,
Richard A. Barth
1   Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California
› Author Affiliations
Further Information

Publication History

13 January 2014

23 January 2014

Publication Date:
02 May 2014 (online)

Abstract

While ultrasound (US) has been a part of prenatal care for almost 40 years, technical progress over the last two decades has resulted in improved image quality and detection rate of congenital anomalies. The past 15 years have also seen the expansion of three-dimensional (3D) US, providing enhancements over with 2D US, and more realistic images of babies to parents and providers. Fetal magnetic resonance imaging (MRI) was first performed over 30 years ago, and has undergone major technical improvement over the past 15 to 20 years. Fetal MRI complements US by providing better visualization in the fetus when US is limited such as in oligohydramnios or severe maternal obesity. It offers a larger field of view and better tissue contrast than US and is not limited by shadowing from osseous structures. However, MRI has a limited resolution compared with US, is less readily available, and more expensive. While indications for fetal MRI have been clearly established for some abnormalities, such as neurological anomalies, other indications especially for fetal body imaging are not as clearly defined. In this article, we discuss recent developments in fetal MRI and 3D US and their common and newest indications.

 
  • References

  • 1 Colombani M, Rubesova E, Potier A , et al. Management of fetal mediastinal shift: a practical approach [in French]. J Radiol 2011; 92 (2) 118-124
  • 2 Lewis DA, Reickert C, Bowerman R, Hirschl RB. Prenatal ultrasonography frequently fails to diagnose congenital diaphragmatic hernia. J Pediatr Surg 1997; 32 (2) 352-356
  • 3 Zamora IJ, Cass DL, Lee TC , et al. The presence of a hernia sac in congenital diaphragmatic hernia is associated with better fetal lung growth and outcomes. J Pediatr Surg 2013; 48 (6) 1165-1171
  • 4 Athanasiadis AP, Zafrakas M, Arnaoutoglou C, Karavida A, Papasozomenou P, Tarlatzis BC. Prenatal diagnosis of thoracic kidney in the 2nd trimester with delayed manifestation of associated diaphragmatic hernia. J Clin Ultrasound 2011; 39 (4) 221-224
  • 5 Ruano R, Lazar DA, Cass DL , et al. Fetal lung volume and quantification of liver herniation by magnetic resonance imaging in isolated congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2013;
  • 6 Rypens F, Metens T, Rocourt N , et al. Fetal lung volume: estimation at MR imaging-initial results. Radiology 2001; 219 (1) 236-241
  • 7 Barnewolt CE, Kunisaki SM, Fauza DO, Nemes LP, Estroff JA, Jennings RW. Percent predicted lung volumes as measured on fetal magnetic resonance imaging: a useful biometric parameter for risk stratification in congenital diaphragmatic hernia. J Pediatr Surg 2007; 42 (1) 193-197
  • 8 Deshmukh S, Rubesova E, Barth R. MR assessment of normal fetal lung volumes: a literature review. AJR Am J Roentgenol 2010; 194 (2) W212-7
  • 9 Victoria T, Bebbington MW, Danzer E , et al. Use of magnetic resonance imaging in prenatal prognosis of the fetus with isolated left congenital diaphragmatic hernia. Prenat Diagn 2012; 32 (8) 715-723
  • 10 Gorincour G, Bouvenot J, Mourot MG , et al; Groupe Radiopédiatrique de Recherche en Imagerie Foetale (GRRIF). Prenatal prognosis of congenital diaphragmatic hernia using magnetic resonance imaging measurement of fetal lung volume. Ultrasound Obstet Gynecol 2005; 26 (7) 738-744
  • 11 Kitano Y, Nakagawa S, Kuroda T , et al. Liver position in fetal congenital diaphragmatic hernia retains a prognostic value in the era of lung-protective strategy. J Pediatr Surg 2005; 40 (12) 1827-1832
  • 12 Walsh DS, Hubbard AM, Olutoye OO , et al. Assessment of fetal lung volumes and liver herniation with magnetic resonance imaging in congenital diaphragmatic hernia. Am J Obstet Gynecol 2000; 183 (5) 1067-1069
  • 13 Hedrick HL, Danzer E, Merchant A , et al. Liver position and lung-to-head ratio for prediction of extracorporeal membrane oxygenation and survival in isolated left congenital diaphragmatic hernia. Am J Obstet Gynecol 2007; 197 (4) e1-e4
  • 14 Kays DW, Islam S, Larson SD, Perkins J, Talbert JL. Long-term maturation of congenital diaphragmatic hernia treatment results: toward development of a severity-specific treatment algorithm. Ann Surg 2013; 258 (4) 638-644 , discussion 644–645
  • 15 Jani J, Keller RL, Benachi A , et al; Antenatal-CDH-Registry Group. Prenatal prediction of survival in isolated left-sided diaphragmatic hernia. Ultrasound Obstet Gynecol 2006; 27 (1) 18-22
  • 16 Lipshutz GS, Albanese CT, Feldstein VA , et al. Prospective analysis of lung-to-head ratio predicts survival for patients with prenatally diagnosed congenital diaphragmatic hernia. J Pediatr Surg 1997; 32 (11) 1634-1636
  • 17 Suda K, Bigras JL, Bohn D, Hornberger LK, McCrindle BW. Echocardiographic predictors of outcome in newborns with congenital diaphragmatic hernia. Pediatrics 2000; 105 (5) 1106-1109
  • 18 Achiron R, Hegesh J, Yagel S. Fetal lung lesions: a spectrum of disease. New classification based on pathogenesis, two-dimensional and color Doppler ultrasound. Ultrasound Obstet Gynecol 2004; 24 (2) 107-114
  • 19 Crombleholme TM, Coleman B, Hedrick H , et al. Cystic adenomatoid malformation volume ratio predicts outcome in prenatally diagnosed cystic adenomatoid malformation of the lung. J Pediatr Surg 2002; 37 (3) 331-338
  • 20 Levine D, Barnewolt CE, Mehta TS, Trop I, Estroff J, Wong G. Fetal thoracic abnormalities: MR imaging. Radiology 2003; 228 (2) 379-388
  • 21 Barth RA. Imaging of fetal chest masses. Pediatr Radiol 2012; 42 (Suppl. 01) S62-S73
  • 22 Azizkhan RG, Crombleholme TM. Congenital cystic lung disease: contemporary antenatal and postnatal management. Pediatr Surg Int 2008; 24 (6) 643-657
  • 23 Rubesova E, Newman B, Dutta S, Gary EH, Rosenberg J, Barth R. Management of bronchopulmonary malformations: results of the SPR and ESPR survey. Paper presented at: 51st Annual Meeting of the Society for Pediatric Radiology; July 5–October 5, 2008 ; Scottsdale, AZ
  • 24 Solt I, Rotmensch S, Bronshtein M. The esophageal 'pouch sign': a benign transient finding. Prenat Diagn 2010; 30 (9) 845-848
  • 25 Salomon LJ, Sonigo P, Ou P, Ville Y, Brunelle F. Real-time fetal magnetic resonance imaging for the dynamic visualization of the pouch in esophageal atresia. Ultrasound Obstet Gynecol 2009; 34 (4) 471-474
  • 26 Mong A, Johnson AM, Kramer SS , et al. Congenital high airway obstruction syndrome: MR/US findings, effect on management, and outcome. Pediatr Radiol 2008; 38 (11) 1171-1179
  • 27 Bouchard S, Johnson MP, Flake AW , et al. The EXIT procedure: experience and outcome in 31 cases. J Pediatr Surg 2002; 37 (3) 418-426
  • 28 Nyberg DA, Dubinsky T, Resta RG, Mahony BS, Hickok DE, Luthy DA. Echogenic fetal bowel during the second trimester: clinical importance. Radiology 1993; 188 (2) 527-531
  • 29 Mailath-Pokorny M, Klein K, Klebermass-Schrehof K, Hachemian N, Bettelheim D. Are fetuses with isolated echogenic bowel at higher risk for an adverse pregnancy outcome? Experiences from a tertiary referral center. Prenat Diagn 2012; 32 (13) 1295-1299
  • 30 Chan KL, Tang MH, Tse HY, Tang RY, Tam PK. Meconium peritonitis: prenatal diagnosis, postnatal management and outcome. Prenat Diagn 2005; 25 (8) 676-682
  • 31 Biyyam DR, Dighe M, Siebert JR. Antenatal diagnosis of intestinal malrotation on fetal MRI. Pediatr Radiol 2009; 39 (8) 847-849
  • 32 Rubesova E. Fetal bowel anomalies—US and MR assessment. Pediatr Radiol 2012; 42 (Suppl. 01) S101-S106
  • 33 Brugger PC, Prayer D. Fetal abdominal magnetic resonance imaging. Eur J Radiol 2006; 57 (2) 278-293
  • 34 Veyrac C, Couture A, Saguintaah M, Baud C. MRI of fetal GI tract abnormalities. Abdom Imaging 2004; 29 (4) 411-420
  • 35 Saguintaah M, Couture A, Veyrac C, Baud C, Quere MP. MRI of the fetal gastrointestinal tract. Pediatr Radiol 2002; 32 (6) 395-404
  • 36 Lubusky M, Prochazka M, Dhaifalah I, Horak D, Geierova M, Santavy J. Fetal enterolithiasis: prenatal sonographic and MRI diagnosis in two cases of urorectal septum malformation (URSM) sequence. Prenat Diagn 2006; 26 (4) 345-349
  • 37 Nemec U, Nemec SF, Bettelheim D , et al. Ovarian cysts on prenatal MRI. Eur J Radiol 2012; 81 (8) 1937-1944
  • 38 Gupta P, Sharma R, Kumar S , et al. Role of MRI in fetal abdominal cystic masses detected on prenatal sonography. Arch Gynecol Obstet 2010; 281 (3) 519-526
  • 39 Chaumoitre K, Brun M, Cassart M , et al. Differential diagnosis of fetal hyperechogenic cystic kidneys unrelated to renal tract anomalies: A multicenter study. Ultrasound Obstet Gynecol 2006; 28 (7) 911-917
  • 40 Cassart M, Massez A, Metens T , et al. Complementary role of MRI after sonography in assessing bilateral urinary tract anomalies in the fetus. AJR Am J Roentgenol 2004; 182 (3) 689-695
  • 41 Cerwinka WH, Damien Grattan-Smith J, Kirsch AJ. Magnetic resonance urography in pediatric urology. J Pediatr Urol 2008; 4 (1) 74-82 , quiz 82–83
  • 42 Calvo-Garcia MA, Kline-Fath BM, Rubio EI, Merrow AC, Guimaraes CV, Lim FY. Fetal MRI of cloacal exstrophy. Pediatr Radiol 2013; 43 (5) 593-604
  • 43 Chen CP, Chang TY, Liu YP , et al. Prenatal 3-dimensional sonographic and MRI findings in omphalocele-exstrophy-imperforate anus-spinal defects complex. J Clin Ultrasound 2008; 36 (5) 308-311
  • 44 Chauvin NA, Epelman M, Victoria T, Johnson AM. Complex genitourinary abnormalities on fetal MRI: imaging findings and approach to diagnosis. AJR Am J Roentgenol 2012; 199 (2) W222-31
  • 45 Biard JM, Wilson RD, Johnson MP , et al. Prenatally diagnosed giant omphaloceles: short- and long-term outcomes. Prenat Diagn 2004; 24 (6) 434-439
  • 46 Danzer E, Victoria T, Bebbington MW , et al. Fetal MRI-calculated total lung volumes in the prediction of short-term outcome in giant omphalocele: preliminary findings. Fetal Diagn Ther 2012; 31 (4) 248-253
  • 47 McMahon CJ, Taylor MD, Cassady CI, Olutoye OO, Bezold LI. Diagnosis of pentalogy of cantrell in the fetus using magnetic resonance imaging and ultrasound. Pediatr Cardiol 2007; 28 (3) 172-175
  • 48 Grigore M, Iliev G, Gafiteanu D, Cojocaru C. The fetal abdominal wall defects using 2D and 3D ultrasound. Pictorial essay. Med Ultrasound 2012; 14 (4) 341-347
  • 49 Kassa AM, Lilja HE. Predictors of postnatal outcome in neonates with gastroschisis. J Pediatr Surg 2011; 46 (11) 2108-2114
  • 50 Nick AM, Bruner JP, Moses R, Yang EY, Scott TA. Second-trimester intra-abdominal bowel dilation in fetuses with gastroschisis predicts neonatal bowel atresia. Ultrasound Obstet Gynecol 2006; 28 (6) 821-825
  • 51 Anveden-Hertzberg L, Gauderer MW. Paraumbilical intestinal remnant, closed abdominal wall, and midgut loss in a neonate. J Pediatr Surg 1996; 31 (6) 862-863
  • 52 Krakow D, Lachman RS, Rimoin DL. Guidelines for the prenatal diagnosis of fetal skeletal dysplasias. Genet Med 2009; 11 (2) 127-133
  • 53 Muscatello A, Mastrocola N, Di Nicola M, Patacchiola F, Carta G. Correlation between 3D ultrasound appearance and postnatal findings in bilateral malformations of the fetal hands. Fetal Diagn Ther 2012; 31 (2) 138-140
  • 54 Wu CJ, Huang KH, Liu JY. Prenatal 2D and 3D ultrasound diagnosis of radial ray defects. Int J Gynaecol Obstet 2011; 113 (2) 158-159
  • 55 Victoria T, Epelman M, Coleman BG , et al. Low-dose fetal CT in the prenatal evaluation of skeletal dysplasias and other severe skeletal abnormalities. AJR Am J Roentgenol 2013; 200 (5) 989-1000
  • 56 Macé G, Sonigo P, Cormier-Daire V , et al. Three-dimensional helical computed tomography in prenatal diagnosis of fetal skeletal dysplasia. Ultrasound Obstet Gynecol 2013; 42 (2) 161-168
  • 57 McCollough CH, Schueler BA, Atwell TD , et al. Radiation exposure and pregnancy: when should we be concerned?. Radiographics 2007; 27 (4) 909-917 , discussion 917–918
  • 58 Connolly SA, Jaramillo D, Hong JK, Shapiro F. Skeletal development in fetal pig specimens: MR imaging of femur with histologic comparison. Radiology 2004; 233 (2) 505-514
  • 59 Nemec SF, Nemec U, Brugger PC, Wadhawan I, Prayer D. Skeletal development on fetal magnetic resonance imaging. Top Magn Reson Imaging 2011; 22 (3) 101-106
  • 60 Sun HY, Boe J, Rubesova E, Barth RA, Tacy TA. Fetal MRI Correlates with Postnatal CT Angiogram Assessment of Pulmonary Anatomy in Tetralogy of Fallot with Absent Pulmonary Valve. Congenit Heart Dis 2013;
  • 61 Manganaro L, Savelli S, Di Maurizio M , et al. Potential role of fetal cardiac evaluation with magnetic resonance imaging: preliminary experience. Prenat Diagn 2008; 28 (2) 148-156
  • 62 Hata T, Yonehara T, Aoki S, Manabe A, Hata K, Miyazaki K. Three-dimensional sonographic visualization of the fetal face. AJR Am J Roentgenol 1998; 170 (2) 481-483
  • 63 Merz E, Abramovicz J, Baba K , et al. 3D imaging of the fetal face - recommendations from the International 3D Focus Group. Ultraschall Med 2012; 33 (2) 175-182
  • 64 Levi S, Hyjazi Y, Schaapst JP, Defoort P, Coulon R, Buekens P. Sensitivity and specificity of routine antenatal screening for congenital anomalies by ultrasound: the Belgian Multicentric Study. Ultrasound Obstet Gynecol 1991; 1 (2) 102-110
  • 65 Crane JP, LeFevre ML, Winborn RC , et al; The RADIUS Study Group. A randomized trial of prenatal ultrasonographic screening: impact on the detection, management, and outcome of anomalous fetuses. Am J Obstet Gynecol 1994; 171 (2) 392-399
  • 66 Johnson DD, Pretorius DH, Budorick NE , et al. Fetal lip and primary palate: three-dimensional versus two-dimensional US. Radiology 2000; 217 (1) 236-239
  • 67 Chmait R, Pretorius D, Moore T , et al. Prenatal detection of associated anomalies in fetuses diagnosed with cleft lip with or without cleft palate in utero. Ultrasound Obstet Gynecol 2006; 27 (2) 173-176
  • 68 Pooh RK, Kurjak A. 3D/4D sonography moved prenatal diagnosis of fetal anomalies from the second to the first trimester of pregnancy. J Matern Fetal Neonatal Med 2012; 25 (5) 433-455
  • 69 Murphy A, Platt LD. First-trimester diagnosis of body stalk anomaly using 2- and 3-dimensional sonography. J Ultrasound Med 2011; 30 (12) 1739-1743
  • 70 Victoria T, Roberts T, Johnson A , et al. Fetal MRI—jumping from 1.5 to 3 tesla MRI: preliminary experience. Paper presented at: 55th Annual Meeting of the Society for Pediatric Radiology; April 16–20, 2012 ; San Antonio, TX
  • 71 Kasprian G, Del Río M, Prayer D. Fetal diffusion imaging: pearls and solutions. Top Magn Reson Imaging 2010; 21 (6) 387-394
  • 72 Manganaro L, Perrone A, Sassi S , et al. Diffusion-weighted MR imaging and apparent diffusion coefficient of the normal fetal lung: preliminary experience. Prenat Diagn 2008; 28 (8) 745-748
  • 73 Cannie M, Jani J, De Keyzer F, Roebben I, Dymarkowski S, Deprest J. Diffusion-weighted MRI in lungs of normal fetuses and those with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2009; 34 (6) 678-686
  • 74 Chaumoitre K, Colavolpe N, Shojai R, Sarran A, D' Ercole C, Panuel M. Diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient (ADC) determination in normal and pathological fetal kidneys. Ultrasound Obstet Gynecol 2007; 29 (1) 22-31
  • 75 Houshmand G, Hosseinzadeh K, Ozolek J. Prenatal magnetic resonance imaging (MRI) findings of a foregut duplication cyst of the tongue: value of real-time MRI evaluation of the fetal swallowing mechanism. J Ultrasound Med 2011; 30 (6) 843-850
  • 76 Levine D, Cavazos C, Kazan-Tannus JF , et al. Evaluation of real-time single-shot fast spin-echo MRI for visualization of the fetal midline corpus callosum and secondary palate. AJR Am J Roentgenol 2006; 187 (6) 1505-1511
  • 77 Plaisier A, Raets MM, van der Starre C , et al. Safety of routine early MRI in preterm infants. Pediatr Radiol 2012; 42 (10) 1205-1211