Prenatal and Postnatal Diagnosis of Rhabdomyomas and Tuberous Sclerosis Complex by Ultrafast and Standard MRI
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To examine the features of cardiac rhabdomyomas and tuberous sclerosis in fetuses and infants using magnetic resonance imaging (MRI) and to determine whether MRI is an effective tool to facilitate early detection of tuberous sclerosis complex (TSC).
Fifteen patients with TSC were evaluated by ultrafast or standard MRI between June 2005 and September 2016. Fifteen patients were divided into two groups. Group A included five cases in utero and followed in infancy with gestational ages from 26 + 1 to 38 + 2 wk. Group B included ten cases aged from 36 d to 18-mo-old.
There were 11 and 10 cardiac lesions of prenatal and postnatal period respectively in five subjects of Group A and 27 cardiac lesions in ten subjects of Group B. There were more than 31 prenatal brain lesions and 30 postnatal brain lesions in Group A and 169 lesions in Group B. Standard postnatal brain MRI confirmed the prenatal study of Group A. At 1 y follow up of Group A, there was partial regression of 2 cardiac lesions, complete regression of 1 cardiac lesion, no obvious regression of 8 cardiac lesions.
When one or multiple cardiac tumors are detected by ultrasound in fetal period or some specific clinical manifestations are presented in infancy, fetal ultrafast MRI or standard MRI is suggested to make early diagnosis of TSC.
KeywordsMRI Rhabdomyomas Tuberous sclerosis Central nervous system Fetus Infant
The authors are grateful to their adviser Dr. Steven Saris for reading the manuscript and making many valuable suggestions and revision for improvement.
All of the MR images were reviewed cooperatively by three radiologists (YZ, SZD and YMZ). The specialties of these three evaluating radiologists are all fetal and pediatric imaging diagnosis, they have dedicated to this field for more than 10 to 20 y. The clinical manifestations and US results were reviewed and discussed at the time of acquisition and when the MR images were interpreted. AMS helped to identify the cardiac lesions of each case. Professor Ming Zhu, a Chinese famous pediatric radiologist, he has studied fetal MRI for more than 10 y; he can take a responsibility that the facts and figures given in the manuscript are true and the article is not under consideration by any other Journal / is not duplicate publication.
Compliance with Ethical Standards
Conflict of Interest
Source of Funding
National Natural Science Foundation of China (81101032): Fetal MRI combined with 1H MRS quantitative assessment of fetal lung development and oligohydramnios complicated with pulmonary dysplasia National Natural Science Foundation of China (81571628): The diagnosis of fetal congenital heart disease based on the precise qualitative and quantitative MRI scanning technology.
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