Importance of Fetal MRI in Evaluation of Craniofacial Deformities

Abstract

This retrospective study aims at demonstrating the importance of a correct and detailed early diagnosis of craniomaxillofacial malformations affecting the fetus, which would (1) allow improvement in ultrasonography (US) diagnosis, (2) help in planning the therapeutic-surgical procedure, and (3) improve handling of the pathology by the families. Between 2008 and 2011, a sample of 28 fetuses was selected, all with an ultrasound diagnosis of cleft lip (cheiloschisis-CL) and cleft lip and palate (palatoschisis-CLP) and craniofacial malformation, whose mothers had all underwent ultrasound diagnostic examinations and nuclear magnetic resonance (MRI). All cases were submitted to US examination between the 12th and 19th week of pregnancy, US-3D examination performed by a specialist radiologist between the 19th and 22nd week, and MRI examination between the 23rd and 33rd week of pregnancy. The MRI confirmed the ultrasound diagnosis of 16/28 cases and added information in 11/28 cases, and in 1 (1/28) case, the MRI denied previous CL-CLP ultrasound diagnosis. Moreover, in this study MRI improved the analysis of the entire morphology of the fetuses in cases when syndromic involvement with the involvement of other organs needs to be determined. The MRI method in fetal patients allows to obtain more details regarding the CL-CLP studied, allowing the medical-surgical team to plan, before the birth, the type of postnatal assessment and surgery to be performed, thus minimizing the impact on neonatal health and improving quality of life of both the patient and his family.