Diagnosis of fetal congenital limb deformities by MRI

Abstract

Objective To explore the diagnostic value of MRI on fetal congenital limb deformities.Methods Sixteen pregnant women,aged from 22 to 40 years (average 29 years) and with gestation from 22 to 39 weeks (average 29 weeks) were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies. Acquisitions consisted of coronal, sagittal, and axial slices relative to the fetal brain, spine, thorax, abdomen, especially limbs using 2D FIESTA sequences. Prenatal US and MR imaging findings were compared with postnatal diagnoses (4 fetuses) or autopsy (12 pregnant women,13 fetuses). Postnatal evaluation included US, MR imaging, computed tomography, and physical examination. Results Of the sixteen pregnant women (15 with a single fetus and 1 with twin fetuses) ,17 fetuses were found. Those limb deformities of sixteen pregnant women included congenital both upper extremities amelia (1 case), sirenomelia sequence (1 case), micmmelia (5 cases, 1 of which were twins),bilateral clenched hands (2 cases), right pelydactyly (1 case), simple right ectrodactyly (1 case), right dactylolysis(1 case), simple club foot (2 cases), hydrocele spinalis with club foot (2 cases), 1 of the 2 cases with bilateral clinodactyly. In 14 of 16 cases, the diagnoses established by MR imaging were correct when compared with postnatal diagnosis, and prenatal MR diagnosis was inaccurate in 2 cases. Conclusion Prenatal MRI is effective in the assessment of congenital limb deformities of fetuses, it can yield information additional to that obtained with US, and further correct US diagnosis. Key words: Limb deformities, congenital; Fetus; Magnetic resonance imaging