Fetal Posterior Fossanın MR Değerlendirmesi

Amaç: Fetal manyetik rezonans görüntülemenin MRG posterior fossa PF anomalilerinde kullanımı konusunda farklı yayınlar mevcuttur. Bu çalışmada merkezimizde fetal PF anomalilerinin MRG ile değerlendirme sonuçları incelenmiştir. Purpose: Various studies have been published on the use of fetal magnetic resonance imaging MRI in the assessment of posterior fossa PF abnormalities. In this study, MRI results of fetal PF analysis in our center have been evaluated. Gereç ve Yöntem: Bölümümüze refere edilen fetal MRG olguları retrospektif olarak veri tabanı incelemesi ile çıkarıldı. İkinci ya da 3. trimesterde fetal MRG yapılmış toplam 308 olgu arasından fetal PF anomalisi tanısı olan hastalar tespit edildi. Bulgular: Toplam 308 olgunun 47’sinde ortalama gestasyonel yaş 25.2 hafta PF anomalisi tespit edildi. En sık görülen anomaliler sırasıyla, mega sisterna magna 18 , Arnold-Chiari II malformasyonu 12 , oksipital ensefalosel 6 , Dandy–Walker malformasyonu 5 , araknoid kist 3 ve diğer 3 olarak izlendi. Postnatal takip edilen 23, termine edilen 17, takipten çıkan 7 fetus oldu. Sonuç:Fetal MRG kullanımının PF değerlendirmesinde yaygınlaşması eşlik eden bulguların saptanması ve nadir görülen anomalilerin tespiti nedeniyle klinisyene yol göstermesi ve ailelerin bilgilendirilmesi açısından önemlidir.

Mri Assessment of Fetal Posterior Fossa

Purpose: Various studies have been published on the use of fetal magnetic resonance imaging MRI in the assessment of posterior fossa PF abnormalities. In this study, MRI results of fetal PF analysis in our center have been evaluated. Methods and Material: The fetal MRG cases that were referred to our department have been retrieved by database search retrospectively. Among 308 fetal MRI cases that were examined at second or third the fetuses with PF anomalies were recruited.Results: Of the 308 fetuses, 47 mean gestational age 25.2 weeks had PF abnormalities. The most common abnormalities were, mega cysterna magna 18 , Arnold-Chiari II malformation 12 , occipital encephalocele 6 , Dandy–Walker malformation 5 , arachnoid cyst 3 and others 3 respectively. Twenty-three fetuses were followed-up, 17 terminated, 7 fetuses were lost to follow-up.Conclusion: The increased use of fetal MRI in the assessment of PF is important in consulting the clinician and the families by demonstrating the associated anomalies and detecting the rarely observed findings

___

1. Guibaud L Anomalies de la fosse cerebrale posterieure. In: Garel C, Del- ezoide AL, Guibaud L (eds) Imagerie du cerveau foetal pathologique. Sauramps Medical, Montepellier, 2002: 99– 118.

2. Altman NR, Naidich TP, Braffman BH Posterior fossa malformations. AJNR 1992; 13:691–724.

3. Kollias SS, Ball WS Jr, Prenger EC Cystic malformations of the posterior fossa: differential diagnosis clarified through embryologic analysis. Radiographics.1993:13:1211–1231.

4. Laurent Guibaud. Practical approach to prenatal posterior fossa abnormalities using MRI.Pediatr Radiol. 2004: 34: 700–711.

5. Poutamo J, Vanninen R, Partanen K, et al. Magnetic resonance imaging supplements ultrasonographic imaging of the posterior fossa, pharynx and neck in malformed fetuses. Ultrasound Obstet Gynecol 1999; 13:327–34.

6. Malinger G, Lev D, Lerman-Sagie T.The fetal cerebellum. Pitfalls in diagnosis and management. Prenat Diagn. 2009;29(4):372-80.

7. Limperopoulos C, Robertson RL Jr, Khwaja OS, Robson CD, Estroff JA, Barnewolt C, Levine D, Morash D, Nemes L, Zaccagnini L, du Plessis AJ. How Accurately Does Current Fetal Imaging Identify Posterior Fossa Anomalies? AJR Am J Roentgenol. 2008;190(6):1637-43.

8. Gandolfi Colleoni G, Contro E, Carletti A, Ghi T, Campobasso G, Rembouskos G, Volpe G, Pilu G, Volpe P. Prenatal diagnosis and outcome of fetal posterior fossa fluid collections. Ultrasound Obstet Gynecol. 2012 Jun;39(6):625-31.

9. Ozcan Aksoy Umit, Prenatal diagnosis of cerebral venous pathologies: Findings in DWI, TOF and gradient echo sequences. Clin Neuroradiol. 2013 Mar 24. [Epub ahead of print] 10. Levine D. Atlas of Fetal MRI. FL; 2005.

11. Dror R, Malinger G, Ben-Sira L, Lev D, Pick C, Lerman-Sagie T. Enlargement of the fetal posterior fossa--what is the significance? Harefuah. 2008;147(11):873-8, 941.

12. Dror R, Malinger G, Ben-Sira L, Lev D, Pick CG, Lerman-Sagie T. Developmental outcome of children with enlargement of the cisterna magna identified in utero. J Child Neurol. 2009;24(12):1486-92.

13. Patek KJ, Kline-Fath BM, Hopkin RJ, Pilipenko VV, Crombleholme TM, Spaeth CG. Posterior fossa anomalies diagnosed with fetal MRI: associated anomalies and neurodevelopmental outcomes. Prenat Diagn. 2012;32(1):75-82.

14. Hayward R. Postnatal management and outcome for fetaldiagnosed intra-cerebral cystic masses and tumours. Prenat Diagn. 2009 Apr;29(4):396-401

15. Utsunomiya H, Yamashita S, Takano K, Ueda Y, Fujii A.Midline cystic malformations of the brain: imaging diagnosis and classification based on embryologic analysis.Radiat Med. 2006 Jul;24(6):471-81

16. Adamsbaum C, Moutard ML, Andre C, Merzoug V, Ferey S, Quere MP,et al. MRI of the fetal posterior fossa. Pediatr Radiol. 2005;35(2):124- 40.

17. Smith AB, Gupta N, Otto C, Glenn OA. Diagnosis of Chiari III malformation by second trimester fetal MRI with postnatal MRI and CT correlation. Pediatr Radiol. 2007;37(10):1035-8.

18. Aksoy Özcan Ü, Işık U, Damlacık A, Lembet A, Bodur H, Erzen C, Sav A. Acıbadem Üniversitesinde ve Dünyada Fetal Nörolojiye Multidisipliner Yaklaş ım. Acıbadem Üniversitesi Sağ lık Bilimleri Dergisi2010 (1)s5-8

Acıbadem Üniversitesi Sağlık Bilimleri Dergisi-Cover
  • ISSN: 1309-470X
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2010
  • Yayıncı: ACIBADEM MEHMET ALİ AYDINLAR ÜNİVERSİTESİ