The Prenatal Diagnosis of Facial Clefts with Fetal MRI
Orofacial clefts are among the most common congenital anomalies caused by abnormal facial development during gestation. As prenatal ultrasonography becomes a routine practice in pregnancy, antenatal detection of facial clefts is possible and improves adequate counseling of the prospective parents and planning of obstetrical and neonatal management. However, the prenatal detection rate, especially of isolated cleft palate, is low. Limitations of ultrasonography include acoustic shadowing from the surrounding structures, poor image quality in case of lack of amniotic fluid or maternal obesity, and limited soft tissue contrast. Fetal MRI is a valuable alternative to ultrasonography providing superior tissue contrast and imaging planes in any orientation regardless of the fetal lie and is increasingly used for detailed assessment of inconclusive sonographic findings. In this article, we describe our experience in evaluating the accuracy of both, prenatal ultrasound and magnetic resonance imaging in detecting the position and extent of a cleft as well as the presence of any associated anomalies.
KeywordsAmniotic Fluid Tooth Germ Alveolar Ridge Fetal Magnetic Resonance Image Orofacial Cleft
- Berge, S.J., Palth, H., Van de Vondel, P.T., Appel, T., Niederhagen, B., Von Lindern, J.J., Reich, R.H., Hansmann, M.: Fetal cleft lip and palate: sonographic diagnosis, chromosomal abnormalities, associated anomalies and postnatal outcome in 70 fetuses. Ultrasound Obstet Gynecol 18, 422–431 (2001)PubMedCrossRefGoogle Scholar
- Demircioglu, M., Kangesu, L., Ismail, A., Lake, E., Hughes, J., Wright, S., Sommerland, B.C.: Increasing accuracy of antenatal ultrasound diagnosis of cleft lip with or without cleft palate, in cases referred to the North Thames London Region. Ultrasound Obstet Gynecol 31, 647–651 (2008)PubMedCrossRefGoogle Scholar
- Gorlin, R.J., Cohen, M.M., Hennekam, R.C.M.: Syndromes of the Head and Neck, 4th edn. Oxford University Press, New York (2001)Google Scholar
- Papadopulos, N.A., Papadopoulos, M.A.: Can intrauterine surgery improve the quality of life of cleft lip and palate patients? Hippokratia 7, 59–80 (2003)Google Scholar
- Royal College of Obstetricians and Gynecologists Working Party: Routine Ultrasound Screening in Pregnancy-Protocol, Standards and Training. RCOG Press, London (2000)Google Scholar