Why was it done?
A level II ultrasound performed due to advanced maternal age detected a fetal lung abnormality. MR imaging was requested to further characterize the lesion.
How the study was performed:
For most MR exams, the imaging sequences and scan orientation are determined before the exam is started. This cannot be done with fetal imaging because the fetus may be constantly changing position during the study. To maximize image quality, short sequences are utilized and the mother is asked to hold her breath. Each scan orientation (sagittal, axial or coronal) is based on the position of the fetus during the preceding scan. The radiologist works real time with the technologist to optimize the results.
What the study showed:
The MRI confirmed a mass occupying most of the right lower hemithorax. The lesion is comprised of multiple cystic masses. The most likely diagnosis is type I congenital cystic adenomatoid malformation.
How did the exam impact patient management?
The exam excluded two other diagnostic considerations, congenital diaphragmatic hernia and congenital lobar emphysema. These lesions have different surgical considerations and outcomes.
The MRI study also evaluated the abdominal contents and confirmed that the fetus has normal abdominal situs.
