Fetal MRI of Urine and Meconium by Gestational Age for the Diagnosis of Genitourinary and Gastrointestinal Abnormalities
Nabeel Farhataziz1,
Jennifer E. Engels1,
Ronald M. Ramus2,
Michael Zaretsky2 and
Diane M. Twickler1,2
1 Department of Radiology, University of Texas Southwestern Medical Center, 5323
Harry Hines Blvd., Dallas, TX 75390-8896.
2 Department of Obstetrics and Gynecology, University of Texas Southwestern
Medical Center, Dallas, TX 75390-9032.
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Fig. 1A. —MRI of normal genitourinary and gastrointestinal systems in
fetus at 22 weeks' gestation. Axial T2-weighted image at level of bladder
shows increased signal intensity in bladder (B) and decreased signal intensity
in rectum (R).
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Fig. 1B. —MRI of normal genitourinary and gastrointestinal systems in
fetus at 22 weeks' gestation. Axial T1-weighted image through bladder (B)
shows decreased signal intensity. No bright signal can be identified in
expected region of rectosigmoid colon (R).
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Fig. 2A. —MRI of normal genitourinary and gastrointestinal systems in
fetus at 30 weeks' gestation. Axial T2-weighted image through level of bladder
(B) shows increased signal intensity. Decreased signal intensity is noted in
rectum (R).
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Fig. 2B. —MRI of normal genitourinary and gastrointestinal systems in
fetus at 30 weeks' gestation. Axial T1-weighted image through level of bladder
shows decreased signal in bladder (B) and increased signal in rectum (R).
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Fig. 2C. —MRI of normal genitourinary and gastrointestinal systems in
fetus at 30 weeks' gestation. Axial T2-weighted image shows increased signal
intensity in left renal pelvis (black arrow) and decreased signal
intensity in colon in left upper quadrant (C and white arrows).
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Fig. 2D. —MRI of normal genitourinary and gastrointestinal systems in
fetus at 30 weeks' gestation. Coronal T1-weighted image shows increased signal
intensity in colon (C and solid arrow) and decreased signal intensity
in right renal pelvis (open arrow).
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Fig. 3A. —MRI of fetus at 29 weeks' gestation with prune-belly
syndrome. Axial T2-weighted image at level of bladder shows large bladder (B)
and dilated ureters (short arrows)—all with increased signal
intensity. Amniotic fluid (AF) and ascites also have increased signal
intensity. Rectum (long arrow) is noted to have decreased signal
intensity. Placenta (P) is noted.
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Fig. 3B. —MRI of fetus at 29 weeks' gestation with prune-belly
syndrome. Axial T1-weighted image through level of bladder shows decreased
signal intensity in bladder (B) and ureters (u). Increased signal intensity is
noted in rectum (R).
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Fig. 3C. —MRI of fetus at 29 weeks' gestation with prune-belly
syndrome. Axial T2-weighted image at level of kidneys shows increased signal
intensity in renal pelves (solid arrows) and increased signal
intensity in enlarged bladder (B). Marked contour abnormalities of anterior
abdominal wall (open arrows) are noted in this case of prune-belly
syndrome. Placenta (P), amniotic fluid (AF), and fetal spine (S) are
noted.
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Fig. 3D. —MRI of fetus at 29 weeks' gestation with prune-belly
syndrome. Gross photograph of fetus shows anterior abdominal wall deformity
and impressions on anterior abdominal wall secondary to massively dilated
ureters.
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Fig. 4A. —MRI of twins at 29 weeks' gestation with meconium peritonitis
in twin B secondary to small-bowel atresia. Twin B did not have cystic
fibrosis. Coronal T2-weighted image of twin B shows bright signal intensity in
bladder (B). Ascites (white arrows) is present, consisting of fluid
with slightly less signal intensity than bladder and stomach (S). Placenta (P)
and twin A are noted.
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Fig. 4B. —MRI of twins at 29 weeks' gestation with meconium peritonitis
in twin B secondary to small-bowel atresia. Twin B did not have cystic
fibrosis. Coronal T1-weighted image of twin B shows ascites (arrows)
to have intermediate signal intensity, and signal intensity in stomach (S) and
bladder (B) is decreased.
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Fig. 4C. —MRI of twins at 29 weeks' gestation with meconium peritonitis
in twin B secondary to small-bowel atresia. Twin B did not have cystic
fibrosis. T1-weighted image of both twins A and B shows twin A to have several
normal-appearing loops of colon (+) with increased signal intensity and
decreased signal intensity in bladder (B). Twin B is noted to have ascites
(arrows), which is intermediate in signal intensity; no
normal-appearing bright loops of colon are identified in twin B.
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Fig. 4D. —MRI of twins at 29 weeks' gestation with meconium peritonitis
in twin B secondary to small-bowel atresia. Twin B did not have cystic
fibrosis. Axial T2-weighted image of twin B shows dilated loops of bowel
(white arrows) with intermediate signal fluid. Ascites (black
arrows) is noted to have slightly higher signal intensity than adjacent
bowel contents. Placenta and twin A are noted.
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Fig. 4E. —MRI of twins at 29 weeks' gestation with meconium peritonitis
in twin B secondary to small-bowel atresia. Twin B did not have cystic
fibrosis. Axial T1-weighted image of twin B shows dilated loops of bowel
(arrows) containing fluid with intermediate signal intensity. No
normal-appearing colon with increased signal intensity is identified. Twin A
is noted.
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Fig. 5A. —MRI of fetus at 37 weeks' gestation with extraadrenal
neuroblastoma. Sagittal T2-weighted image shows increased signal intensity of
fluid in stomach (S) and moderate hydronephrosis of left kidney
(arrow). Large soft-tissue mass (M) with intermediate signal
intensity is seen anterior to left kidney and inferior in relation to stomach.
Normal-appearing small bowel (SB) is also visualized.
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Fig. 5B. —MRI of fetus at 37 weeks' gestation with extraadrenal
neuroblastoma. Axial T2-weighted image shows moderate left hydronephrosis (+)
and large intermediate-signal-intensity mass (M) anteriorly. Small bowel (SB)
and fetal spine (S) are noted.
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Fig. 5C. —MRI of fetus at 37 weeks' gestation with extraadrenal
neuroblastoma. Axial T1-weighted image through level of liver (L) shows large
soft-tissue mass (M) that is intermediate in signal intensity. Meconium-filled
colon (C) shows increased T1 signal and is lateral to mass.
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Copyright © 2005 by the American Roentgen Ray Society.
