Aims and objectives
Current knowledge about fetal intracranial hemorrhage (ICH) [1] could be summarized as follows:
Mostly occurs in the absence of identifiable risk factors.
The most common form of presentation is intraventricular hemorrhage (IVH).
knowledge of prenatal diagnosis criteria and prognosis of ICH is limited,
especially in cases in which the primary lesion is not IVH.
Up to 80% of fetuses with ventriculomegaly (VM) have additional abnormalities,
including ICH among one of its causes.
[2]
The criteria and prenatal diagnostic classifications are based mainly on ultrasound findings,...
Methods and materials
A retrospective study,
from January 2006 to November 2018,
of 15 fetuses studied by MRI because of suspected cerebral pathology on cerebral US,
in which MRI revealed ICH.
The characteristics of our study population are summarized in Table 1.
Two expert radiologists in fetal imaging reviewed the clinical histories and US imaging studies to correlate them with MRI and postnatal imaging findings or necropsy,
when available.
The following classification system was used (Currently used in neonates to classify fetal ICH by US) [6,
7]:
IVH...
Results
MRI signs of ICH were described in all the 15 cases.
US suspected ICH in only 5 cases (33%),
which were later confirmed by MRI.
In 10 fetuses (67%),
referred for suspicion of another intracranial pathology,
MRI changed the diagnosis to ICH.
In 1 fetus (7%),
MRI findings did not match with pathological or postnatal imaging findings.
Tables 5 and 6 show the findings described in the MRI compared to those found in the anatomopathological studies of some of the fetuses that underwent a necropsy.
Conclusion
Based on the results of our study and what has been published in the literature,
it has been seen that fetal MRI facilitates the diagnosis of fetal ICH and better depicts the location and extent of ICH compared to US,
although MRI also has its limitations.
Due to the small number of cases and publications on fetal ICH,
the role of fetal MRI in this entity is not well established.
More studies are needed to be able to unify diagnostic criteria,
define key findings and...
References
Sanapo L,
Whitehead M,
Bulas D,
et al: Fetal intracranial hemorrhage role of fetal MRI.
prenatal diagnosis 2017; 37(8)
Shaowei Y,
Quan N,
et al: Contribution of MRI to Detect Further Anomalies in Fetal Ventriculomegaly.
Fetal Diagnosis Therapy 2010; 27:20–24
Fong KW,
Ghai S,
Toi A,
et al: Prenatal ultrasound findings of lissencephaly associated with Miller-Dieker syndrome and comparison with pre- and postnatal magnetic resonance imaging.
Ultrasound Obstet Gynecol 2004; 24: 716–723.
Rosen MG,
Dickinson JC: The incidence of cerebral palsy.
Am J Obstet Gynecol...