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      Pictorial essay: MRI of the fetal brain

      meeting-report
      Author(s): , 1
      Publication date (Print):
      Journal: The Indian Journal of Radiology & Imaging
      Publisher: Medknow Publications
      Keywords: Brain, fetal, MRI

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          Abstract

          MRI is a useful supplement to USG for the assessment of fetal brain malformations. Superior soft tissue contrast and the ability to depict sulcation and myelination are the strengths of MRI. Subtle or inconclusive USG abnormalities can be confirmed or ruled out by MRI. In some cases, additional findings detected with MRI often help in arriving at a definitive diagnosis, which is necessary for parental counseling and for guiding management. Fast T2W sequences form the basis of fetal MRI. There have been no reports of deleterious effects of MRI on the fetus. A few case examples are presented to illustrate the advantages of MRI.

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          Most cited references39

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          The use of iodinated and gadolinium contrast media during pregnancy and lactation.

          , Henrik S. Thomsen, Nicholas Webb … (2005)
          The use of iodinated or gadolinium-based contrast media in pregnant or lactating women often causes concerns in the radiology department because of the principle of not exposing a fetus or neonate to any drugs. Because of the uncertainty about the use of contrast media during pregnancy and lactation, the Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and draw up guidelines. An extensive literature search was carried out and summarized in a report. Based on the limited information available, simple guidelines have been drawn up. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain. Mutagenic and teratogenic effects have not been described after administration of gadolinium or iodinated contrast media. Free iodide in radiographic contrast medium given to the mother has the potential to depress fetal/neonatal thyroid function. Neonatal thyroid function should be checked during the 1st week if iodinated contrast media have been given during pregnancy. No effect on the fetus has been seen after gadolinium contrast media. Only tiny amounts of iodinated or gadolinium-based contrast medium given to a lactating mother reach the milk, and only a minute proportion entering the baby's gut is absorbed. The very small potential risk associated with absorption of contrast medium may be considered insufficient to warrant stopping breast-feeding for 24 h following either iodinated or gadolinium contrast agents.
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            Safety considerations in MR imaging.

            F Shellock, E Kanal, S Talagala (1990)
            The authors identify eight areas of potential safety concern during clinical magnetic resonance (MR) imaging. These include (a) biologic effects of the static magnetic field; (b) ferromagnetic attractive "projectile" effects of the static magnetic field; (c) potential effects of the relatively slowly time-varying magnetic field gradients; (d) effects of the rapidly varying radio-frequency (RF) magnetic fields, including RF power deposition concerns; (e) auditory considerations from noise caused by the rapidly pulsed magnetic field gradients; (f) safety considerations concerning superconductive systems, including quenches, use of cryogens, and cryogen storage and handling; (g) psychological effects, such as claustrophobia and anxiety induced because of the examination; and (h) possible effects of the intravenous use of the MR contrast agent gadopentetate dimeglumine. The concerns in each of these categories are elaborated upon, and the available data are presented to clarify their status.
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              Fetal MRI: normal gestational landmarks for cerebral biometry, gyration and myelination.

              Guy Sebag, Catherine Garel, Hervé Brisse … (2003)
              Up until the last 10 years, normal cerebral gestational landmarks were assessed by ultrasonographic and fetopathologic studies. The purpose of this paper is to display the possibilities provided by fetal MRI in the evaluation of fetal cerebral biometry, normal sulcation and myelination. Two hundred and twenty-five fetuses (with a normal brain) were studied prospectively using a standardised method. The gestational age ranged from 22 to 38 weeks. The main data concerning biometry of various cerebral structures at those terms are given. In contrast to ultrasound, MRI allows measurements of brain (and not skull), which are available independently of the position of the fetal head. The timing of the appearance of the different sulci is also available using MRI. It is considered to be a good marker of fetal brain maturation. The biochemical modifications contemporary to myelination make it possible to evaluate this phenomenon in the fetal brain using MRI.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Radiol Imaging
                Journal ID (publisher-id): IJRI
                Title: The Indian Journal of Radiology & Imaging
                Publisher: Medknow Publications (India )
                ISSN (Print): 0971-3026
                ISSN (Electronic): 1998-3808
                Publication date (Print): February 2009
                Volume: 19
                Issue: 1
                Pages: 69-74
                Affiliations
                Ragavs Diagnostic and Research Centre, Sadguru Complex, 27 th Cross, 4 th Block, West, Jayanagar, Bangalore- 560 011, India
                [1 ]Srinivasa Ultrasound Scanning Centre, 48/2, Shankar Mutt Road, Shankarpuram, Bangalore - 560 004, India
                Author notes
                Correspondence: Dr. Ganesh Rao B, Ragavs Diagnostic and Research Centre, Sadguru Complex, 27 th Cross, 4 th Block, West, Jayanagar, Bangalore- 560 011, India. E-mail: ganeshrao406@ 123456hotmail.com
                Article
                Publisher ID: IJRI-19-69
                DOI: 10.4103/0971-3026.45349
                PMC ID: 2747421
                PubMed ID: 19774144
                SO-VID: 8edd52c7-d2f7-4e10-ad93-011797702e72
                Copyright © © Indian Journal of Radiology and Imaging
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Obstetric Symposium

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: mri,fetal,brain
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: mri, fetal, brain

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