Related Experiment Video
Updated: Apr 4, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Prenatal Brain Imaging in Isolated vs. Complicated Club Foot: A Cohort Study
I Gat1, O Bar Yosef2, C Hoffmann3
1Antenatal Diagnostic Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Insights
Fetal brain MRI is valuable for complex talipes equinovarus (TEV) cases, revealing more abnormalities than ultrasound. Its benefit in isolated TEV requires further study.
Area of Science:
- Medical Imaging
- Fetal Medicine
- Neurology
Background:
- Talipes equinovarus (TEV) is a common congenital anomaly.
- Differentiating isolated from complex TEV is crucial for prognosis and management.
- Complex TEV is associated with poorer neurological outcomes, necessitating fetal brain evaluation.
Purpose of the Study:
- To assess the utility of fetal brain magnetic resonance imaging (MRI) in evaluating fetuses with TEV.
- To compare the diagnostic yield of fetal brain MRI with ultrasound (US) in TEV cases.
- To determine the contribution of fetal brain MRI to antenatal diagnosis and management.
Main Methods:
- Retrospective review of pregnant patients referred for fetal brain MRI due to TEV.
- Classification of TEV into isolated and complex based on associated anomalies.
- Comparison of brain US findings with fetal brain MRI results.
- Analysis of diagnostic discrepancies between US and MRI.
Main Results:
- Fetal brain MRI identified additional pathologies in 57.1% of complex TEV cases, compared to 28.6% with US.
- MRI revealed abnormalities not detected by US in 6 cases of complex TEV.
- In isolated TEV cases, both US and MRI were largely normal, with limited added value from MRI.
Conclusions:
- Fetal brain MRI is an effective tool for antenatal evaluation of complicated TEV, detecting more anomalies than US.
- The role of fetal brain MRI in isolated TEV cases is less clear and warrants further investigation.
- Fetal brain MRI is relevant for evaluating non-central nervous system (CNS) anomalies associated with TEV.
Abstract:
Purpose: Talipes equinovarus (TEV) is a common birth defect. Differentiation between isolated and complex TEV is fundamental due to its effect on prognosis. Association between TEV and poor neurological outcome is more prominent in complex cases and highlights the significance of brain evaluation. The aim of the current study was to evaluate the contribution of fetal brain MRI to sonographic evaluation. Materials and Methods: In this retrospective study we evaluated charts of all pregnant patients referred for fetal brain MRI due to fetal TEV between 1/1/2011 and 12/31/14 in a single tertiary referral center. Isolated and complex TEV were differentiated according to associated anomalies. Brain US and MRI results were compared. Results: 28 pregnant patients were included with an average gestation and parity of 2.5 and 1.5, respectively. Both isolated and complicated TEV groups included 14 fetuses after initial TEV diagnosis on anatomical survey. Brain sonography and MRI were normal among 12/14 patients with isolated TEV while two patients were later diagnosed with mild ventriculomegaly. US brain evaluation has revealed pathologic findings in 4 (28.6 %) cases in the complicated TEV group, while MRI demonstrated abnormal findings in 8 (57.1 %) fetuses with notable severity diversity. In 6 cases, MRI diagnosed additional pathologies which were not demonstrated by US. Conclusion: Brain fetal MRI is an efficient tool during antenatal evaluation of complicated TEV with a high percentage of additional findings not demonstrated songraphically while its efficacy in isolated cases is in doubt. The current study expands the relevance of fetal brain MRI in cases of non-CNS anomalies.
