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Updated: Jul 22, 2026
Murine Fetal Echocardiography
Published on: February 15, 2013
Fetal thoracic abnormalities: MR imaging
Deborah Levine1, Carol E Barnewolt, Tejas S Mehta
1Departments of Radiology and Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA. dlevine@caregroup.harvard.edu
Purpose:
To elucidate the appearance of fetal thoracic abnormalities at prenatal magnetic resonance (MR) imaging and determine whether MR imaging yields information additional to that obtained with ultrasonography (US).
Materials And Methods:
US and MR imaging data from 83 MR examinations of 74 fetuses with thoracic abnormalities and confirmatory US performed within 1 week before MR imaging were compared with respect to resulting changes in patient counseling and/or care. Lung parenchyma and lesion signal intensities and vascularity, airway, esophagus, and diaphragm appearances were reviewed retrospectively on MR images. Student t tests and analyses of variance were performed.
Results:
MR imaging yielded information additional to that acquired with US in 28 (38%) of 74 fetuses. The additional findings were confirmed in 19 of the 28 fetuses at postnatal follow-up; no follow-up data were available for the other nine fetuses. Thoracic MR information affected care with regard to six (8%) of 74 fetuses. Mean gestational age of 15 fetuses with lung signal intensity (SI) slightly lower than that of amniotic fluid (28.4 weeks +/- 6.8 [SD]) at T2-weighted MR imaging was significantly older than that of 18 fetuses with intermediate SI (21.3 weeks +/- 4.3) (P <.05). Mean SI of 13 congenital cystic adenomatoid malformations (CCAMs) and/or sequestrations (1.74 +/- 1.05) at T2-weighted MR imaging was significantly higher than that of the normal lungs of 33 fetuses (2.63 +/-.63) (P <.001). Among nine studies in which vessels were visualized in CCAMs and/or sequestrations, six involved a normal vascular branching pattern. Portions of the esophagus were seen in 31 (36%) of 85 fetuses. Nonvisualization of a major airway was not sufficient for diagnosis of pulmonary atresia. Visualization of a portion of the esophagus did not correlate with esophageal atresia. In all except one fetus, who had anhydramnios and pulmonary hypoplasia, and the fetuses with congenital diaphragmatic hernia, at least a portion of the diaphragm was visualized at MR imaging.
Conclusion:
MR imaging yields information additional to that yielded with US in fetuses with thoracic abnormalities.
Insights
Prenatal magnetic resonance (MR) imaging provides additional diagnostic information for fetal thoracic abnormalities compared to ultrasonography (US). This advanced imaging technique can alter patient care and counseling in a significant number of cases.
Area of Science:
- Medical Imaging
- Fetal Medicine
- Radiology
Background:
- Prenatal diagnosis of fetal thoracic abnormalities is crucial for planning management.
- Ultrasonography (US) is the primary imaging modality, but its limitations may necessitate further investigation.
Purpose of the Study:
- To describe the appearance of fetal thoracic abnormalities using prenatal magnetic resonance (MR) imaging.
- To evaluate whether MR imaging offers supplementary information beyond US findings.
Main Methods:
- Retrospective review of US and MR imaging data from 74 fetuses with thoracic abnormalities.
- Comparison of imaging findings to assess changes in patient counseling and care.
- Analysis of lung parenchyma, lesions, vascularity, airways, esophagus, and diaphragm on MR images.
Main Results:
- MR imaging provided additional information in 38% of fetuses, influencing care in 8%.
- Specific findings included variations in lung signal intensity and visualization of CCAMs/sequestrations.
- Diaphragm visualization was common, but airway and esophageal findings required careful interpretation.
Conclusions:
- Prenatal MR imaging is a valuable tool for evaluating fetal thoracic abnormalities.
- It complements US by providing additional details that can impact clinical decision-making.
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