Learning objectives
To describe the normal magnetic resonance imaging features of the fetal thoracic anatomy
To illustrate the magnetic resonance imaging features of the most common congenital thoracic anomalies
Background
Congenital thoracic anomalies are rare,
and they may involve the lung parenchyma,
bronchi,
arterial supply,
and venous drainage.
The most common congenital thoracic anomalies are congenital pulmonary airway malformation (CPAM),
bronchopulmonary sequestration (BPS),
congenital lobar fluid overload (CLFO),
and congenital diaphragmatic hernia (CDH).
Accurate prenatal diagnosis of congenital thoracic anomalies is important because the natural history and treatment of these lesions differ.
Accurate characterization allows better prenatal counseling and appropriate prenatal and postnatal management.
Prenatal ultrasonography (US) has been used for routine screening in pregnancy....
Findings and procedure details
Normal Fetal Chest on MRI
T2-weighted images are the most useful for evaluating the lung anatomy.
The trachea,
bronchi,
and lungs reveal homogeneous hyperintensity on T2-weighted images (Fig.
1) in comparison to chest wall muscles,
because they contain a significant amount of amniotic and alveolar fluid.
An increase in the signal intensity of the lungs can be observed as the lungs mature.
In cases of lung compression,
the amount of alveolar fluid is decreased,
resulting in a more hypointense signal.
Other structure that can be...
Conclusion
MR imaging plays an important role as complementary method to ultrasound due to its ability to show multiple planes and its greater tissue differentiation.
Its main indication is the assessment of diaphragmatic hernia.
It can demonstrate hernia contents,
quantify lung volume better than US and helps in planning delivery and postnatal surgery.
MR imaging can also be used to distinguish different types of congenital pulmonary airway malformation,
identify the systemic vessels of pulmonary sequestration better than US.
References
1. Cannie M,
Jani J,
De Keyzer F,
et al.
Magnetic resonance imaging of the fetal lung: a pictorial essay.
Eur Radiol 2008; 18: 1364-1374
2. Stocker JT.
Cystic lung disease in infants and children.
Fetal Pediatr Pathol 2009; 28: 155-184
3. Bolde S,
Pudale S,
Pandit G,
Ruikar K,
Ingle SB.
Congenital pulmonary airway malformation: A report of two cases.
World J Clin Cases 2015; 3(5): 470-473
4. Stocker JT.
Congenital pulmonary airway malformation: a new name for and an expanded classification of congenital...