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Fetal Magnetic Resonance Imaging in the Evaluation of Fetuses Referred for Sonographically Suspected Abnormalities of the Corpus Callosum

Departments of Radiology (O.A.G., R.B.G., K.C.L., S.J.Y., M.E.N., A.J.B.) and Obstetrics and Gynecology (M.E.N.), University of California, San Francisco, San Francisco, California USA; Prenatal Diagnosis Center, California Pacific Medical Center, San Francisco, California USA (J.D.G.); and General Electric Applied Sciences Laboratory West, Menlo Park, California USA (R.F.B.).

Address correspondence to Orit A. Glenn, MD, Department of Radiology, Neuroradiology Section, University of California, San Francisco, 505 Parnassus Ave, Box 0628, San Francisco, CA 94143-0628 USA. E-mail: orit.glenn{at}radiology.ucsf.edu

Objective. Fetal magnetic resonance imaging (MRI) has been shown to be useful in assessing the developing central nervous system. However, its utility in specific brain disorders has not been well investigated. We hypothesized that fetal MRI can better assess the integrity of the brain in cases with sonographically suspected callosal abnormalities. Methods. We retrospectively reviewed fetal MRI and prenatal sonographic studies of 10 fetuses referred for MRI for sonographically suspected callosal abnormalities. Results. An abnormal corpus callosum was identified on fetal MRI in 80% of cases. The type of callosal abnormality (complete or partial agenesis) was similar on both prenatal sonography and fetal MRI in all cases. All sonographically identified additional brain abnormalities were detected on fetal MRI, with the exception of choroid plexus cysts. Furthermore, in 63% (5 of 8) of cases with a callosal abnormality on both sonography and fetal MRI, additional brain abnormalities were detected on fetal MRI that were not apparent on sonography. These sonographically occult findings were confirmed on postnatal MRI or autopsy in 3 of 5 patients. Conclusions. Fetal MRI is an important adjunct to sonography in assessing the corpus callosum and other aspects of brain development when agenesis of the corpus callosum is suspected. It can identify frequent additional findings that are not visible on sonography such as abnormal sulcation. In light of the association between additional brain abnormalities and worse neurodevelopmental outcome, the potential of fetal MRI as an important adjunctive prognostic imaging test in fetuses with callosal agenesis can now be tested.

Key Words: corpus callosum agenesis • fetal magnetic resonance imaging • sonography

Abbreviations: LMP, last menstrual period • MRI, magnetic resonance imaging • SSFSE, Single-shot fast spin echo

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