Click on any image below to see an enlargement of that image.

Case 1: Normal singleton gestation	Case 2: Normal twin gestation
Case 3: Congenital facial tumor (left and right)
(left)	(right)
Case 4: Hydrocephalus (left and right)
(left)	(right)
Case 5: Degenerated fibroid tumor	Case 6: Dermoid tumor

Above images are all original MR scans performed at Parkside MR Center.

Imaging Breakthrough

“Ultrasound has been a diagnostic tool used to evaluate pregnancies for over twenty years. In the past decade ultrasound has become extremely sensitive in evaluating the fetus not only for dating and growth abnormalities, but also for the presence or absence of congenital anomalies. Occasionally, targeted ultrasound will suggest a fetal or maternal pelvic abnormality but will be unable to yield an exact diagnosis that is required to make management decisions. In these unusual situations, prognosis and plan of management for the pregnancy may be guided by a more specific diagnosis. Fetal diagnosis suggested or made by targeted ultrasound for which additional information might be sought through an MRI examination would include: some central nervous system anomalies, occasional urinary tract anomalies with oligohydramnios, unusual fetal tumors, and rarely for evaluation of placental abnormalities. MRI examination may also be of benefit in the workup and management of maternal lesions of the uterus and pelvis. When clinical examination or basic ultrasound suggests fetal or maternal pelvic abnormality, targeted ultrasound should be performed in an attempt to make an exact diagnosis. If this ultrasound examination raises questions regarding prognosis and management, MRI examination should be considered.”

Dr. Bruce Pielet, M.D.
Perinatology, Lutheran General Hospital

Discussion

MRI has recently provided an alternative to ultrasound in the evaluation of both the fetus and pregnant mother. MR imaging in pregnancy can aid in fetal evaluation when prenatal ultrasound detects an uncertain or atypical in-utero fetal anomaly or when ultrasound is limited by fetal position or diminished amniotic fluid. Studies are performed with "fast scan" techniques that usually require no sedation. No adverse effects to the fetus are known from MR imaging, however, for added safety, MRI examinations are usually performed only after the first trimester.¹

Fetal MRI can provide valuable information in a wide variety of circumstances. When prenatal ultrasound reveals hydrocephalus, for example, MRI can evaluate the degree and cause of ventricular enlargement. MRI has also been shown to be more accurate than ultrasound in the diagnosis of fetal congenital chest lesions.² In addition, the information afforded by MRI can have substantial effect on the management of the pregnancy.³

MR imaging can also be safely used in the evaluation of the pregnant patient with abdominal or pelvic pain. Pancreatitis, the cause of biliary colic, the assessment of renal colic and the etiology of uterine and adnexal pain are some examples.

References

To find out more about Prenatal Imaging and other services at Parkside MR Center, visit our web site at www.parksidemri.com or call us at (847) 696-7900.

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