Prenatal imaging of amniotic band sequence: utility and role of fetal MRI as an adjunct to prenatal US
Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Pediatric Radiology
(Impact Factor: 1.57).
12/2011; 42(5):544-51. DOI: 10.1007/s00247-011-2296-8
Amniotic band sequence and its US manifestations have been well-described. There is little information, however, regarding the accuracy and utility of fetal MRI.
To describe the MRI findings in amniotic band sequence and to compare the diagnostic accuracy of MRI and US.
Prenatal MRI and US studies were retrospectively reviewed in 14 consecutive pregnancies with confirmed amniotic band sequence. Both studies were evaluated for amniotic band visualization, body part affected, type of deformity, umbilical cord involvement and vascular abnormality.
Amniotic bands were confidently identified with MRI in 8 fetuses (57%), suggested with MRI in 3 fetuses (21%) and confidently seen by US in 13 fetuses (93%). Neither modality detected surgically proven bands on one fetus. Both techniques were equally able to define the body part affected and the type of deformity. At least one limb abnormality was visualized in all cases and truncal involvement was present in two cases. Cord involvement was identified in seven cases, with one case detected only by MRI.
Fetal MRI is able to visualize amniotic bands and their secondary manifestations and could be complementary to prenatal US when fetal surgery is contemplated.
Available from: Aleef Rahman
Available from: Aleef Rahman
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To describe the spectrum of clinical deformities related to amniotic band sequence (ABS), ranging from mild to severe.
Retrospective evaluation of 9 cases of ABS managed during a 4-year period (February 2006 to April 2010) in a tertiary hospital.
The median gestational age at prenatal diagnosis was 15 weeks (range 11-26). Only 2 patients had clinical prenatal evidence of amnion rupture. In the other 5 cases the diagnosis of ABS was established prenatally based on fetal structural abnormalities. These abnormalities included: (1) upper limb defects: syndactyly, amputation at the level of phalanges or first metacarpal or forearm; (2) inferior extremities defects: tallus equinovarus and flexed knee, and constriction ring; (3) umbilical cord strangulation, and (4) acrania.
ABS is a polymorphous syndrome and recognizing its various manifestations can be of help in prenatal identification.
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