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MRI signs of intrauterine fetal demise

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Abstract

Intrauterine fetal demise (IUFD) is an uncommon but serious event that may occasionally be encountered on fetal MRI. Compared to the more florid signs of fetal demise which has occurred some time ago, recent IUFD is associated with more subtle findings that may be missed or misinterpreted. The two main MRI sequences used in imaging the fetus are T2-like two-dimensional balanced steady-state free-precession (SSFP), a white blood sequence, or T2-weighted single-shot fast spin-echo (SSFSE), a black blood sequence. The most reliable and specific signs of a recent IUFD are a constricted heart with poorly delineated cardiac chambers and signal abnormality in the heart and aorta, which will have different features depending on the MRI sequence used. Secondary signs of IUFD include global brain ischemia, abnormal globes, effusions, body wall edema and umbilical cord thrombosis. Unlike fetal ultrasound examinations where cardiac activity is routinely assessed, fetal MRI requires careful scrutiny of the fetal heart for assessment of fetal life.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Imaging, KK Womens’ and Childrens’ Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore

    Eelin Tan, Joel Cheng’en Zhou, Omar Mahmood, Chiou Li Ong & Chee Hui Ng

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  1. Eelin Tan
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Supplementary Video 1. Dynamic SSFP imaging demonstrating fetal cardiac activity in a viable fetus (MP4 79 kb)

Supplementary Video 2. Dynamic SSFP imaging demonstrating absent fetal cardiac activity in a demised fetus (MP4 80 kb)

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Tan, E., Zhou, J.C., Mahmood, O. et al. MRI signs of intrauterine fetal demise. Abdom Radiol 46, 3365–3377 (2021). https://doi.org/10.1007/s00261-021-03031-w

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