Pediatric Radiology

, 41:1117

Fetal MRI clues to diagnose cloacal malformations

  • Maria A. Calvo-Garcia
  • Beth M. Kline-Fath
  • Marc A. Levitt
  • Foong-Yen Lim
  • Leann E. Linam
  • Manish N. Patel
  • Steven Kraus
  • Timothy M. Crombleholme
  • Alberto Peña
Original Article

DOI: 10.1007/s00247-011-2020-8

Cite this article as:
Calvo-Garcia, M.A., Kline-Fath, B.M., Levitt, M.A. et al. Pediatr Radiol (2011) 41: 1117. doi:10.1007/s00247-011-2020-8

Abstract

Background

Prenatal US detection of cloacal malformations is challenging and rarely confirms this diagnosis.

Objective

To define the prenatal MRI findings in cloacal malformations.

Materials and methods

We performed a retrospective study of patients with cloacal malformations who had pre- and post-natal assessment at our institution. Fetal MRI was obtained in six singleton pregnancies between 26 and 32 weeks of gestation. Imaging analysis was focused on the distal bowel, the urinary system and the genital tract and compared with postnatal clinical, radiological and surgical diagnoses.

Results

The distal bowel was dilated and did not extend below the bladder in five fetuses. They had a long common cloacal channel (3.5–6 cm) and a rectum located over the bladder base. Only one fetus with a posterior cloacal variant had a normal rectum. Three fetuses had increased T2 signal in the bowel and two increased T1/decreased T2 signal bladder content. All had renal anomalies, four had abnormal bladders and two had hydrocolpos.

Conclusion

Assessment of the anorectal signal and pelvic anatomy during the third trimester helps to detect cloacal malformations in the fetus. The specificity for this diagnosis was highly increased when bowel fluid or bladder meconium content was identified.

Keywords

CloacaCloacal malformationPrenatal diagnosisFetal MRIAnorectal malformationPrune belly syndrome

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Maria A. Calvo-Garcia
    • 1
  • Beth M. Kline-Fath
    • 1
  • Marc A. Levitt
    • 2
  • Foong-Yen Lim
    • 3
  • Leann E. Linam
    • 4
  • Manish N. Patel
    • 1
  • Steven Kraus
    • 1
  • Timothy M. Crombleholme
    • 3
  • Alberto Peña
    • 2
  1. 1.Department of Radiology, MLC 5031Cincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Colorectal Center for Children, Pediatric SurgeryCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Fetal Care Center of Cincinnati, Pediatric SurgeryCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  4. 4.Department of RadiologyArkansas Children’s HospitalLittle RockUSA