Foetal magnetic resonance imaging and echogenic bowel

To evaluate how foetal magnetic resonance imaging (MRI) may change the diagnosis in cases of ultrasound (U/S) findings of echogenic bowel (EB).

Seventeen foetuses with EB underwent serial U/S examinations, foetal MRI, cystic fibrosis screening and maternal viral serologic tests. MRI protocol included T2-weighted half-Fourier acquired single-shot turbo spin-echo (HASTE) sequence and gradient echo (GE) T1-weighted images. Foetal abdominal MRI analyzed patterns were size and signal of small bowel, colon and rectum, ascites and abdominal mass. All neonates had complete clinical examination, abdominal sonography, and a 6 months clinical follow-up.

Eleven foetuses with isolated EB had normal MRI and normal outcome. In comparison, all the 6 foetuses whose U/S patterns showed associated signs had abnormal MRI (p < 0.001). Five had proven pathology (83.3%: 5/6) and only 1 (16.7%: 1/6) had no proven pathology and normal postnatal outcome (p = 0.001). For those five, foetal MRI showed bowel abnormalities with one case of bowel duplication and four cases of bowel obstruction. Two out of the four cases of bowel obstruction were genetically diagnosed as cystic fibrosis. The two remaining cases were diagnosed as ileal atresia.

MRI could provide additive information in cases of EB associated with bowel dilatation.