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Fetal curarization for prenatal magnetic resonance imaging
F Daffos1, F Forestier, J Mac Aleese
1Centre de diagnostic prénatal et de foetologie, Hôpital Notre Dame de Bon Secours, Paris, France.
Prenatal Diagnosis
|May 1, 1988
Summary
Fetal magnetic resonance imaging revealed left cerebellar lobe atrophy and cisternal dilatation in a 33-week fetus. These findings, initially detected via ultrasound, were confirmed postnatally by CT scan.
Area of Science:
- Neuroimaging
- Fetal Medicine
- Pediatric Radiology
Background:
- Prenatal diagnosis of posterior fossa abnormalities is crucial for early intervention.
- Fetal magnetic resonance (MR) imaging offers detailed anatomical visualization.
- Ultrasound screening can detect potential fetal central nervous system anomalies.
Observation:
- A fetus at 33 weeks gestation underwent MR imaging due to a suspected posterior fossa abnormality identified on ultrasound.
- Fetal movement, a common challenge in fetal MR imaging, was successfully mitigated using vecuronium injection into the umbilical vein under ultrasound guidance.
- The MR imaging procedure was performed safely and effectively, enabling clear visualization of the fetal brain structures.
Findings:
- Fetal MR imaging demonstrated significant atrophy of the left cerebellar lobe.
- Enlargement of the cisterna magna (cisternal dilatation) was observed, associated with the cerebellar hypoplasia.
- Postnatal computed tomography (CT) scan confirmed the findings of left cerebellar atrophy and cisternal dilatation, validating the prenatal MR diagnosis.
Implications:
- This case highlights the utility of fetal MR imaging in characterizing posterior fossa abnormalities.
- Accurate prenatal diagnosis of cerebellar atrophy can aid in planning postnatal management and parental counseling.
- The successful use of neuromuscular blockade in fetal MR imaging demonstrates a potential technique to improve image quality in challenging cases.