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Decreased rectal meconium signal on MRI in fetuses with open spinal dysraphism

Usha D Nagaraj1, Maria A Calvo-Garcia1,2, Arnold C Merrow1,2

  • 1Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Prenatal Diagnosis
|August 11, 2018
PubMed
Abstract

Insights

Rectal meconium signal on fetal MRI in open spinal dysraphism does not reliably predict imperforate anus. This finding may indicate neurogenic bowel in affected fetuses.

Area of Science:

  • Medical Imaging
  • Fetal Medicine
  • Pediatric Surgery

Background:

  • Open spinal dysraphism is a complex congenital condition affecting fetal development.
  • Assessing fetal gastrointestinal anomalies is crucial for prenatal diagnosis and management.
  • Rectal meconium signal on MRI can provide insights into fetal bowel function.

Purpose of the Study:

  • To evaluate the characteristics of rectal meconium signal in fetuses diagnosed with open spinal dysraphism.
  • To correlate fetal MRI findings of rectal meconium with postnatal examinations for anorectal malformations.
  • To investigate the potential association between meconium signal and neurogenic bowel in this population.

Main Methods:

  • Retrospective analysis of fetal MRI scans from 2004-2016.
  • Inclusion criteria: diagnostic T1-weighted images and postnatal follow-up.
  • Evaluation of T1 hyperintense rectal meconium signal and meconium column height.

Main Results:

  • 80% of 115 fetuses with open spinal dysraphism exhibited T1 hyperintense rectal meconium signal.
  • Meconium column height varied with gestational age but was normal in the single case of anorectal malformation.
  • No bowel dilation was observed; lack of normal meconium signal did not correlate with imperforate anus.

Conclusions:

  • Decreased or absent T1-hyperintense rectal meconium signal in fetuses with open spinal dysraphism is not predictive of imperforate anus.
  • The presence or absence of normal meconium signal may reflect neurogenic bowel dysfunction.
  • Further research is needed to fully understand the implications of meconium signal in fetal spinal dysraphism.

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