Pediatric Radiology

, Volume 34, Issue 9, pp 685–693 | Cite as

Fetal MRI: techniques and protocols

  • Daniela Prayer
  • Peter Christian Brugger
  • Lucas Prayer
Minisymposium

Abstract

The development of ultrafast sequences has led to a significant improvement in fetal MRI. Imaging protocols have to be adjusted to the rapidly developing fetal central nervous system (CNS) and to the clinical question. Sequence parameters must be changed to cope with the respective developmental stage, to produce images free from motion artefacts and to provide optimum visualization of the region and focus of interest. In contrast to postnatal studies, every suspect fetal CNS abnormality requires examination of the whole fetus and the extrafetal intrauterine structures including the uterus. This approach covers both aspects of fetal CNS disorders: isolated and complex malformations and cerebral lesions arising from the impaired integrity of the feto-placental unit.

Keywords

Fetus CNS MRI Technique 

Notes

Acknowledgements

The authors wish to thank Fritz Stuhr and JR Lindner for their enthusiasm and their valuable contributions in sequence development and experimental work.

References

  1. 1.
    Smith FW, Adam AH, Phillips WD (1983) NMR imaging in pregnancy. Lancet 1:61–62CrossRefPubMedGoogle Scholar
  2. 2.
    Daffos F, Forestier F, MacAleese J, et al (1988) Fetal curarization for prenatal magnetic resonance imaging. Prenat Diagn 8:313–317Google Scholar
  3. 3.
    Hubbard AM, Harty MP, States LJ (1999) A new tool for prenatal diagnosis: ultrafast fetal MRI. Semin Perinatol 23:437–447PubMedGoogle Scholar
  4. 4.
    Simon EM, Goldstein RB, Coakley FV, et al (2000) Fast MR imaging of fetal CNS anomalies in utero. AJNR 21:1688–1698Google Scholar
  5. 5.
    Ismail KM, Ashworth JR, Martin WL, et al (2002) Fetal magnetic resonance imaging in prenatal diagnosis of central nervous system abnormalities: 3-year experience. J Matern Fetal Neonatal Med 12:185–190PubMedGoogle Scholar
  6. 6.
    Levine D, Barnes PD, Robertson RR, et al (2003) Fast MR imaging of fetal central nervous system abnormalities. Radiology 229:51–61PubMedGoogle Scholar
  7. 7.
    Righini A, Bianchini E, Parazzini C, et al (2003) Apparent diffusion coefficient determination in normal fetal brain: a prenatal MR imaging study. AJNR 24:799–804Google Scholar
  8. 8.
    Girard N, Gire C, Sigaudy S, et al (2003) MR imaging of acquired fetal brain disorders. Childs Nerv Syst 19:490–500CrossRefPubMedGoogle Scholar
  9. 9.
    Girard N, Raybaud C, Gambarelli D, et al (2001) Fetal brain MR imaging. Magn Reson Imaging Clin N Am 9:19–56PubMedGoogle Scholar
  10. 10.
    Koop M, Rilling G, Herrmann A, et al (1986) Volumetric development of the fetal telencephalon, cerebral cortex, diencephalon, and rhombencephalon including the cerebellum in man. Bibl Anat 28:53–78PubMedGoogle Scholar
  11. 11.
    Kinney HC, Karthigasan J, Borenshteyn NI, et al (1994) Myelination in the developing human brain: biochemical correlates. Neurochem Res 19:893–896Google Scholar
  12. 12.
    Levine D, Smith AS, McKenzie C (2003) Tips and tricks of fetal MR imaging. Radiol Clin North Am 41:729–745PubMedGoogle Scholar
  13. 13.
    Larkman DJ, Hajnal JV, Herlihy AH, et al (2001) Use of multicoil arrays for separation of signal from multiple slices simultaneously excited. J Magn Reson Imaging 13:313–317CrossRefPubMedGoogle Scholar
  14. 14.
    Duncan KR (2001) Fetal and placental volumetric and functional analysis using echo-planar imaging. Top Magn Reson Imaging 12:52–66CrossRefPubMedGoogle Scholar
  15. 15.
    Caire JT, Ramus RM, Magee KP, et al (2003) MRI of fetal genitourinary anomalies. AJR 181:1381–1385PubMedGoogle Scholar
  16. 16.
    Glastonbury CM, Kennedy AM (2002) Ultrafast MRI of the fetus. Australas Radiol 46:22–32CrossRefPubMedGoogle Scholar
  17. 17.
    Li T, Mirowitz SA (2003) Fast T2-weighted MR imaging: impact of variation in pulse sequence parameters on image quality and artifacts. Magn Reson Imaging 21:745–753CrossRefPubMedGoogle Scholar
  18. 18.
    Chung HW, Chen CY, Zimmerman RA, et al (2000) T2-weighted fast MR imaging with true FISP versus HASTE: comparative efficacy in the evaluation of normal fetal brain maturation. AJR 175:1375–1380PubMedGoogle Scholar
  19. 19.
    Poutamo J, Vanninen R, Partanen K, et al (1999) Magnetic resonance imaging supplements ultrasonographic imaging of the posterior fossa, pharynx and neck in malformed fetuses. Ultrasound Obstet Gynecol 13:327–334CrossRefPubMedGoogle Scholar
  20. 20.
    Guo WY, Wong TT (2003) Screening of fetal CNS anomalies by MR imaging. Childs Nerv Syst 19:410–414CrossRefPubMedGoogle Scholar
  21. 21.
    Marden FA, Wippold FJ II, Perry A (2003) Fast magnetic resonance imaging in steady-state precession (true FISP) in the prenatal diagnosis of a congenital brain teratoma. J Comput Assist Tomogr 27:427–430CrossRefPubMedGoogle Scholar
  22. 22.
    Ertl-Wagner B, Lienemann A, Strauss A, et al (2002) Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities. Eur Radiol 12:1931–1940PubMedGoogle Scholar
  23. 23.
    Chen Q, Levine D (2001) Fast fetal magnetic resonance imaging techniques. Top Magn Reson Imaging 12:67–79CrossRefPubMedGoogle Scholar
  24. 24.
    Coakley FV, Glenn OA, Qayyum A, et al (2004) Fetal MRI: a developing technique for the developing patient. AJR 182:243–252PubMedGoogle Scholar
  25. 25.
    Hendrick RE, Raff U (1992) Image contrast and noise. In: Bradley WG, Stark DD (eds) Magnetic resonance imaging. Mosby-Yearbook, St. Louis, pp 123–129Google Scholar
  26. 26.
    Shellock FG, Kanal E (1996) Bioeffects and safety of MR procedures, In: Hesselink JR, Zlatkin MB, Edelman RR (eds) Clinical magnetic resonance imaging. Saunders, Philadelphia, p 426Google Scholar
  27. 27.
    Messori A, Polonara G, Salvolini U (2003) Prenatal diagnosis of a vein of Galen aneurysmal malformation with fetal MR imaging study. AJNR 24:1923–1925Google Scholar
  28. 28.
    Kurihara N, Tokieda K, Ikeda K, et al (2001) Prenatal MR findings in a case of aneurysm of the vein of Galen. Pediatr Radiol 31:160–162CrossRefPubMedGoogle Scholar
  29. 29.
    Brunelle F (2003) Brain vascular malformations in the fetus: diagnosis and prognosis. Childs Nerv Syst 19:524–528CrossRefPubMedGoogle Scholar
  30. 30.
    Prayer D, Barkovich AJ, Kirschner DA, et al (2001) Visualization of nonstructural changes in early white matter development on diffusion-weighted MR images: evidence supporting premyelination anisotropy. AJNR 22:1572–1576Google Scholar
  31. 31.
    McKinstry RC, Mathur A, Miller JH, et al (2002) Radial organization of developing preterm human cerebral cortex revealed by non-invasive water diffusion anisotropy MRI. Cereb Cortex 12:1237–1243CrossRefPubMedGoogle Scholar
  32. 32.
    Prayer D, Brugger PC, Mittermayer C (2003) Assessment of intrauterine brain maturation using diffusion weighted imaging. Ultrasound Obstet Gynecol 22 [Suppl 1]:3CrossRefPubMedGoogle Scholar
  33. 33.
    Mori S, Itoh R, Zhang J, et al (2001) Diffusion tensor imaging of the developing mouse brain. Magn Reson Med 46:18–23CrossRefPubMedGoogle Scholar
  34. 34.
    Heidemann RM, Ozsarlak O, Parizel PM, et al (2003) A brief review of parallel magnetic resonance imaging. Eur Radiol 13:2323–2337CrossRefPubMedGoogle Scholar
  35. 35.
    Schierlitz L, Dumanli H, Robinson JN, et al (2001) Three-dimensional magnetic resonance imaging of fetal brains. Lancet 357:1177–1178CrossRefPubMedGoogle Scholar
  36. 36.
    Scifo P, Cachia A, Boddaert N, et al (2004) Antenatal MR imaging for the study of fetus brain development. http://brainvisa.info/pdf/scifo-HBM03.pdf. Cited 11 Feb 2004
  37. 37.
    Arcement CM, Meza MP, Arumanla S, et al (2001) MRCP in the evaluation of pancreaticobiliary disease in children. Pediatr Radiol 31:92–97CrossRefPubMedGoogle Scholar
  38. 38.
    Garel C, Brisse H, Sebag G, et al (1998) Magnetic resonance imaging of the fetus. Pediatr Radiol 28:201–211CrossRefPubMedGoogle Scholar
  39. 39.
    Kok RD, van den Berg PP, van den Bergh AJ, et al (2002) Maturation of the human fetal brain as observed by 1H MR spectroscopy. Magn Reson Med 48:611–616PubMedGoogle Scholar
  40. 40.
    Heerschap A, Kok RD, van den Berg PP (2003) Antenatal proton MR spectroscopy of the human brain in vivo. Childs Nerv Syst 19:418–421CrossRefPubMedGoogle Scholar
  41. 41.
    Kim TH, Joh JH, Kim MY, et al (2002) Fetal pericallosal lipoma: US and MR findings. Korean J Radiol 3:140–143PubMedGoogle Scholar
  42. 42.
    Leung EC, Sgouros S, Williams S (2002) Spinal lipoma misinterpreted as a meningomyelocele on antenatal MRI scan in a baby girl. Childs Nerv Syst 18:361–363PubMedGoogle Scholar
  43. 43.
    Witters I, Moerman P, Fryns JP (2002) Fetal akinesia deformation sequence: a study of 30 consecutive in utero diagnoses. Am J Med Genet 113:23–28CrossRefPubMedGoogle Scholar
  44. 44.
    Yamasaki M, Thompson P, Lemmon V (1997) CRASH syndrome: mutations in L1CAM correlate with severity of the disease. Neuropediatrics 28:175–178PubMedGoogle Scholar
  45. 45.
    Philip N (2003) Screening for genetic disorders. Childs Nerv Syst 19:436–439CrossRefPubMedGoogle Scholar
  46. 46.
    Barkovich JA (2000) Pediatric neuroimaging, 3rd edn. Lippincott, Williams and Wilkins, PhiladelphiaGoogle Scholar
  47. 47.
    Wimberger DM, Roberts TP, Barkovich AJ, et al (1995) Identification of “premyelination” by diffusion-weighted MRI. J Comput Assist Tomogr 19:28–33PubMedGoogle Scholar
  48. 48.
    Sacks LM, Delivoria-Papadopoulos M (1984) Hemoglobin-oxygen interactions. Semin Perinatol 8:168–183PubMedGoogle Scholar
  49. 49.
    Prayer D, Kuhle S, Prokesch R, et al (1999) In vitro MR imaging of blood containing fetal hemoglobin. Radiology 213 [Suppl]:144Google Scholar
  50. 50.
    Mittermayer C, Brugger PC, Chalubinski K, et al (2003) Detection of all stages of fetal cerebral injury in case of in utero growth restricted fetuses with severe pathological Doppler values and in fetuses with premature rupture of membranes. Ultrasound Obstet Gynecol 22 [Suppl 1]:9CrossRefGoogle Scholar
  51. 51.
    Schwindt J, Brugger PC, Mittermayer C, et al (2003) Fetal magnetic resonance imaging (MRI) can visualize evolving periventricular leukomalacia (PVL). Ultrasound Obstet Gynecol 22 [Suppl 1]:21CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Daniela Prayer
    • 1
  • Peter Christian Brugger
    • 2
  • Lucas Prayer
    • 3
  1. 1.Department of Neuroradiology, University Clinics of RadiodiagnosticsMedical University ViennaViennaAustria
  2. 2.Department of Anatomy, Integrative Morphology GroupMedical University ViennaAustria
  3. 3.Diagnosezentrum UraniaViennaAustria

Personalised recommendations