Foetal magnetic resonance imaging and echogenic bowel

Area of Science:

• Perinatology
• Medical Imaging
• Fetal Medicine

Background:

• Echogenic bowel (EB) on prenatal ultrasound can indicate various fetal conditions.
• Differentiating isolated EB from EB with associated anomalies is crucial for management.

Purpose of the Study:

• To assess the diagnostic utility of fetal magnetic resonance imaging (MRI) in cases presenting with echogenic bowel (EB) on ultrasound (U/S).
• To determine if MRI can alter the initial diagnosis suggested by U/S findings of EB.

Main Methods:

• Seventeen fetuses with EB underwent serial U/S, fetal MRI, cystic fibrosis screening, and maternal serologic tests.
• MRI included T2-weighted HASTE and T1-weighted GE sequences, analyzing bowel size/signal, ascites, and abdominal masses.
• Neonatal follow-up included clinical exams, sonography, and 6-month monitoring.

Main Results:

• Isolated EB cases (11/17) showed normal MRI and outcomes.
• Fetuses with EB and associated U/S signs (6/17) had abnormal MRIs (p < 0.001).
• Five of these six fetuses had confirmed pathology: one bowel duplication and four bowel obstructions (two cystic fibrosis, two ileal atresia).

Conclusions:

• Fetal MRI provides valuable additive information in cases of echogenic bowel, particularly when associated with bowel dilatation.
• MRI can help identify specific fetal gastrointestinal abnormalities not evident on ultrasound alone.