Delayed fenestration of Blake's pouch with or without vermian hypoplasia: fetal MRI at 3 tesla versus 1.5 tesla.
Cerebellar vermis
Cranial fossa, posterior
Fetus
Magnetic resonance imaging
Prenatal diagnosis
Journal
Cerebellum & ataxias
ISSN: 2053-8871
Titre abrégé: Cerebellum Ataxias
Pays: England
ID NLM: 101648460
Informations de publication
Date de publication:
2019
2019
Historique:
received:
07
11
2018
accepted:
27
02
2019
entrez:
16
3
2019
pubmed:
16
3
2019
medline:
16
3
2019
Statut:
epublish
Résumé
Fetal magnetic resonance imaging (MRI), mainly performed at standard field strength, plays a role in the classification of posterior fossa malformations. In the context of early second-trimester screening, upward rotation of the cerebellar vermis per se is usually compatible with a more favorable outcome than Dandy-Walker malformation and profound vermian hypoplasia. Delayed fenestration of Blake's pouch may either mimic vermian hypoplasia by compression or be associated with it in individual cases. To increase specificity, there is a growing interest in the use of high-field MRI which is believed to be safe as long as the specific absorption rate is kept within accepted limits. We aim to illustrate its added value during the second and third trimester. In the first case, fetal MRI at 1.5 Tesla was performed at 21 and 27 weeks' gestation with sonographic follow up postnataly. In the second case, 3 Tesla MR images were acquired at 21 and 34 weeks' gestation as well as in the neonatal period. This pictorial case vignette supports the suggestion that mid-gestational MRI at 3 Tesla has the potential to exclude pronounced vermian hypoplasia with higher confidence than at 1.5 Tesla. However, the discrimination of mild hypoplasia from slight deformation of the cerebellar vermis will likely remain challenging.
Sections du résumé
BACKGROUND
BACKGROUND
Fetal magnetic resonance imaging (MRI), mainly performed at standard field strength, plays a role in the classification of posterior fossa malformations. In the context of early second-trimester screening, upward rotation of the cerebellar vermis per se is usually compatible with a more favorable outcome than Dandy-Walker malformation and profound vermian hypoplasia. Delayed fenestration of Blake's pouch may either mimic vermian hypoplasia by compression or be associated with it in individual cases. To increase specificity, there is a growing interest in the use of high-field MRI which is believed to be safe as long as the specific absorption rate is kept within accepted limits. We aim to illustrate its added value during the second and third trimester.
CASE PRESENTATION
METHODS
In the first case, fetal MRI at 1.5 Tesla was performed at 21 and 27 weeks' gestation with sonographic follow up postnataly. In the second case, 3 Tesla MR images were acquired at 21 and 34 weeks' gestation as well as in the neonatal period.
CONCLUSIONS
CONCLUSIONS
This pictorial case vignette supports the suggestion that mid-gestational MRI at 3 Tesla has the potential to exclude pronounced vermian hypoplasia with higher confidence than at 1.5 Tesla. However, the discrimination of mild hypoplasia from slight deformation of the cerebellar vermis will likely remain challenging.
Identifiants
pubmed: 30873288
doi: 10.1186/s40673-019-0098-1
pii: 98
pmc: PMC6402120
doi:
Types de publication
Case Reports
Langues
eng
Pagination
4Déclaration de conflit d'intérêts
The need for approval was waived.Obtained.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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