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Fetal MRI: techniques and protocols

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Abstract

The development of ultrafast sequences has led to a significant improvement in fetal MRI. Imaging protocols have to be adjusted to the rapidly developing fetal central nervous system (CNS) and to the clinical question. Sequence parameters must be changed to cope with the respective developmental stage, to produce images free from motion artefacts and to provide optimum visualization of the region and focus of interest. In contrast to postnatal studies, every suspect fetal CNS abnormality requires examination of the whole fetus and the extrafetal intrauterine structures including the uterus. This approach covers both aspects of fetal CNS disorders: isolated and complex malformations and cerebral lesions arising from the impaired integrity of the feto-placental unit.

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References

  1. Smith FW, Adam AH, Phillips WD (1983) NMR imaging in pregnancy. Lancet 1:61–62

    Article  CAS  PubMed  Google Scholar 

  2. Daffos F, Forestier F, MacAleese J, et al (1988) Fetal curarization for prenatal magnetic resonance imaging. Prenat Diagn 8:313–317

    Google Scholar 

  3. Hubbard AM, Harty MP, States LJ (1999) A new tool for prenatal diagnosis: ultrafast fetal MRI. Semin Perinatol 23:437–447

    CAS  PubMed  Google Scholar 

  4. Simon EM, Goldstein RB, Coakley FV, et al (2000) Fast MR imaging of fetal CNS anomalies in utero. AJNR 21:1688–1698

    CAS  Google Scholar 

  5. Ismail KM, Ashworth JR, Martin WL, et al (2002) Fetal magnetic resonance imaging in prenatal diagnosis of central nervous system abnormalities: 3-year experience. J Matern Fetal Neonatal Med 12:185–190

    CAS  PubMed  Google Scholar 

  6. Levine D, Barnes PD, Robertson RR, et al (2003) Fast MR imaging of fetal central nervous system abnormalities. Radiology 229:51–61

    PubMed  Google Scholar 

  7. Righini A, Bianchini E, Parazzini C, et al (2003) Apparent diffusion coefficient determination in normal fetal brain: a prenatal MR imaging study. AJNR 24:799–804

    Google Scholar 

  8. Girard N, Gire C, Sigaudy S, et al (2003) MR imaging of acquired fetal brain disorders. Childs Nerv Syst 19:490–500

    Article  PubMed  Google Scholar 

  9. Girard N, Raybaud C, Gambarelli D, et al (2001) Fetal brain MR imaging. Magn Reson Imaging Clin N Am 9:19–56

    CAS  PubMed  Google Scholar 

  10. Koop M, Rilling G, Herrmann A, et al (1986) Volumetric development of the fetal telencephalon, cerebral cortex, diencephalon, and rhombencephalon including the cerebellum in man. Bibl Anat 28:53–78

    PubMed  Google Scholar 

  11. Kinney HC, Karthigasan J, Borenshteyn NI, et al (1994) Myelination in the developing human brain: biochemical correlates. Neurochem Res 19:893–896

    Google Scholar 

  12. Levine D, Smith AS, McKenzie C (2003) Tips and tricks of fetal MR imaging. Radiol Clin North Am 41:729–745

    PubMed  Google Scholar 

  13. Larkman DJ, Hajnal JV, Herlihy AH, et al (2001) Use of multicoil arrays for separation of signal from multiple slices simultaneously excited. J Magn Reson Imaging 13:313–317

    Article  CAS  PubMed  Google Scholar 

  14. Duncan KR (2001) Fetal and placental volumetric and functional analysis using echo-planar imaging. Top Magn Reson Imaging 12:52–66

    Article  CAS  PubMed  Google Scholar 

  15. Caire JT, Ramus RM, Magee KP, et al (2003) MRI of fetal genitourinary anomalies. AJR 181:1381–1385

    PubMed  Google Scholar 

  16. Glastonbury CM, Kennedy AM (2002) Ultrafast MRI of the fetus. Australas Radiol 46:22–32

    Article  PubMed  Google Scholar 

  17. Li T, Mirowitz SA (2003) Fast T2-weighted MR imaging: impact of variation in pulse sequence parameters on image quality and artifacts. Magn Reson Imaging 21:745–753

    Article  PubMed  Google Scholar 

  18. Chung HW, Chen CY, Zimmerman RA, et al (2000) T2-weighted fast MR imaging with true FISP versus HASTE: comparative efficacy in the evaluation of normal fetal brain maturation. AJR 175:1375–1380

    CAS  PubMed  Google Scholar 

  19. Poutamo J, Vanninen R, Partanen K, et al (1999) Magnetic resonance imaging supplements ultrasonographic imaging of the posterior fossa, pharynx and neck in malformed fetuses. Ultrasound Obstet Gynecol 13:327–334

    Article  CAS  PubMed  Google Scholar 

  20. Guo WY, Wong TT (2003) Screening of fetal CNS anomalies by MR imaging. Childs Nerv Syst 19:410–414

    Article  PubMed  Google Scholar 

  21. Marden FA, Wippold FJ II, Perry A (2003) Fast magnetic resonance imaging in steady-state precession (true FISP) in the prenatal diagnosis of a congenital brain teratoma. J Comput Assist Tomogr 27:427–430

    Article  PubMed  Google Scholar 

  22. Ertl-Wagner B, Lienemann A, Strauss A, et al (2002) Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities. Eur Radiol 12:1931–1940

    PubMed  Google Scholar 

  23. Chen Q, Levine D (2001) Fast fetal magnetic resonance imaging techniques. Top Magn Reson Imaging 12:67–79

    Article  CAS  PubMed  Google Scholar 

  24. Coakley FV, Glenn OA, Qayyum A, et al (2004) Fetal MRI: a developing technique for the developing patient. AJR 182:243–252

    PubMed  Google Scholar 

  25. Hendrick RE, Raff U (1992) Image contrast and noise. In: Bradley WG, Stark DD (eds) Magnetic resonance imaging. Mosby-Yearbook, St. Louis, pp 123–129

  26. Shellock FG, Kanal E (1996) Bioeffects and safety of MR procedures, In: Hesselink JR, Zlatkin MB, Edelman RR (eds) Clinical magnetic resonance imaging. Saunders, Philadelphia, p 426

  27. Messori A, Polonara G, Salvolini U (2003) Prenatal diagnosis of a vein of Galen aneurysmal malformation with fetal MR imaging study. AJNR 24:1923–1925

    Google Scholar 

  28. Kurihara N, Tokieda K, Ikeda K, et al (2001) Prenatal MR findings in a case of aneurysm of the vein of Galen. Pediatr Radiol 31:160–162

    Article  CAS  PubMed  Google Scholar 

  29. Brunelle F (2003) Brain vascular malformations in the fetus: diagnosis and prognosis. Childs Nerv Syst 19:524–528

    Article  PubMed  Google Scholar 

  30. Prayer D, Barkovich AJ, Kirschner DA, et al (2001) Visualization of nonstructural changes in early white matter development on diffusion-weighted MR images: evidence supporting premyelination anisotropy. AJNR 22:1572–1576

    CAS  Google Scholar 

  31. McKinstry RC, Mathur A, Miller JH, et al (2002) Radial organization of developing preterm human cerebral cortex revealed by non-invasive water diffusion anisotropy MRI. Cereb Cortex 12:1237–1243

    Article  PubMed  Google Scholar 

  32. Prayer D, Brugger PC, Mittermayer C (2003) Assessment of intrauterine brain maturation using diffusion weighted imaging. Ultrasound Obstet Gynecol 22 [Suppl 1]:3

    Article  PubMed  Google Scholar 

  33. Mori S, Itoh R, Zhang J, et al (2001) Diffusion tensor imaging of the developing mouse brain. Magn Reson Med 46:18–23

    Article  CAS  PubMed  Google Scholar 

  34. Heidemann RM, Ozsarlak O, Parizel PM, et al (2003) A brief review of parallel magnetic resonance imaging. Eur Radiol 13:2323–2337

    Article  PubMed  Google Scholar 

  35. Schierlitz L, Dumanli H, Robinson JN, et al (2001) Three-dimensional magnetic resonance imaging of fetal brains. Lancet 357:1177–1178

    Article  CAS  PubMed  Google Scholar 

  36. Scifo P, Cachia A, Boddaert N, et al (2004) Antenatal MR imaging for the study of fetus brain development. http://brainvisa.info/pdf/scifo-HBM03.pdf. Cited 11 Feb 2004

  37. Arcement CM, Meza MP, Arumanla S, et al (2001) MRCP in the evaluation of pancreaticobiliary disease in children. Pediatr Radiol 31:92–97

    Article  CAS  PubMed  Google Scholar 

  38. Garel C, Brisse H, Sebag G, et al (1998) Magnetic resonance imaging of the fetus. Pediatr Radiol 28:201–211

    Article  CAS  PubMed  Google Scholar 

  39. Kok RD, van den Berg PP, van den Bergh AJ, et al (2002) Maturation of the human fetal brain as observed by 1H MR spectroscopy. Magn Reson Med 48:611–616

    CAS  PubMed  Google Scholar 

  40. Heerschap A, Kok RD, van den Berg PP (2003) Antenatal proton MR spectroscopy of the human brain in vivo. Childs Nerv Syst 19:418–421

    Article  PubMed  Google Scholar 

  41. Kim TH, Joh JH, Kim MY, et al (2002) Fetal pericallosal lipoma: US and MR findings. Korean J Radiol 3:140–143

    PubMed  Google Scholar 

  42. Leung EC, Sgouros S, Williams S (2002) Spinal lipoma misinterpreted as a meningomyelocele on antenatal MRI scan in a baby girl. Childs Nerv Syst 18:361–363

    CAS  PubMed  Google Scholar 

  43. Witters I, Moerman P, Fryns JP (2002) Fetal akinesia deformation sequence: a study of 30 consecutive in utero diagnoses. Am J Med Genet 113:23–28

    Article  PubMed  Google Scholar 

  44. Yamasaki M, Thompson P, Lemmon V (1997) CRASH syndrome: mutations in L1CAM correlate with severity of the disease. Neuropediatrics 28:175–178

    CAS  PubMed  Google Scholar 

  45. Philip N (2003) Screening for genetic disorders. Childs Nerv Syst 19:436–439

    Article  PubMed  Google Scholar 

  46. Barkovich JA (2000) Pediatric neuroimaging, 3rd edn. Lippincott, Williams and Wilkins, Philadelphia

  47. Wimberger DM, Roberts TP, Barkovich AJ, et al (1995) Identification of “premyelination” by diffusion-weighted MRI. J Comput Assist Tomogr 19:28–33

    CAS  PubMed  Google Scholar 

  48. Sacks LM, Delivoria-Papadopoulos M (1984) Hemoglobin-oxygen interactions. Semin Perinatol 8:168–183

    CAS  PubMed  Google Scholar 

  49. Prayer D, Kuhle S, Prokesch R, et al (1999) In vitro MR imaging of blood containing fetal hemoglobin. Radiology 213 [Suppl]:144

    Google Scholar 

  50. Mittermayer C, Brugger PC, Chalubinski K, et al (2003) Detection of all stages of fetal cerebral injury in case of in utero growth restricted fetuses with severe pathological Doppler values and in fetuses with premature rupture of membranes. Ultrasound Obstet Gynecol 22 [Suppl 1]:9

    Article  Google Scholar 

  51. Schwindt J, Brugger PC, Mittermayer C, et al (2003) Fetal magnetic resonance imaging (MRI) can visualize evolving periventricular leukomalacia (PVL). Ultrasound Obstet Gynecol 22 [Suppl 1]:21

    Article  Google Scholar 

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Acknowledgements

The authors wish to thank Fritz Stuhr and JR Lindner for their enthusiasm and their valuable contributions in sequence development and experimental work.

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Correspondence to Daniela Prayer.

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Prayer, D., Brugger, P.C. & Prayer, L. Fetal MRI: techniques and protocols. Pediatr Radiol 34, 685–693 (2004). https://doi.org/10.1007/s00247-004-1246-0

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  • DOI: https://doi.org/10.1007/s00247-004-1246-0

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