Ultrasound and Fetal MRI Complementary Contributions to Appropriate Counseling in Small Bowel Obstruction
| Autor: | Anne-Elodie Millischer, Pascale Sonigo, Houman Mahallati, Hortense Didier-Mathon, Elsa Kermorvant, Laurent Salomon, Yves Ville, V. Rousseau, Nathalie Boddaert, David Grevent, Naziha Khen-Dunlop |
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| Rok vydání: | 2021 |
| Předmět: |
Counseling
Embryology medicine.medical_specialty Prenatal counseling Apple peel Ultrasonography Prenatal Fetus Pregnancy medicine Fetal mri Humans Radiology Nuclear Medicine and imaging Retrospective Studies business.industry Ultrasound Infant Newborn Obstetrics and Gynecology General Medicine Short bowel syndrome medicine.disease Magnetic Resonance Imaging Bowel obstruction medicine.anatomical_structure Pediatrics Perinatology and Child Health Duodenum Etiology Female Radiology business Intestinal Obstruction |
| Zdroj: | Fetal Diagnosis and Therapy. 48:567-574 |
| ISSN: | 1421-9964 1015-3837 |
| DOI: | 10.1159/000517728 |
| Popis: | Objective: Bowel obstructions beyond the duodenum represent a heterogeneous group of congenital anomalies with a highly variable prognosis, the main issue being postnatal short bowel syndrome (SBS). The objective of our study was to evaluate the contributions of fetal MRI in cases of bowel obstruction. Materials and Methods: A retrospective analysis of all newborns, for whom both ante-natal ultrasound and fetal MRI were available, referred to our center for suspected bowel obstruction was performed. Examinations were reviewed blinded to the postnatal outcome. Key outcome measures included exact diagnosis and the existence of postoperative SBS. We evaluated the contribution of MRI in determining precise location and etiology of the bowel obstruction, dilatation of the proximal bowel loops, and assessment of the quality of the remaining distal bowel loops. Results: Twenty-five newborns were included. There were 19 single obstructions and 6 complex forms (4 apple peel syndromes and 2 multiple atresias). MRI correctly identified the affected segment of the small bowel in 59.1% of the cases. MRI identified the mechanism of obstruction in 72% of cases. MRI reliably predicted an abnormal appearance of the bowel distal to the obstruction in 100% of the severe cases (3/3) and in 66.7% of complex forms (4/6). Conclusion: Our study suggests that fetal MRI, when done in addition to prenatal ultrasound, is contributory in the management of fetuses with suspected bowel obstruction. MRI may be particularly useful in determining the location and origin of the bowel obstruction and in assessing the quality of the bowel distal to the obstruction, which might assist in the prediction of SBS and more detailed prenatal counseling. |
| Databáze: | OpenAIRE |
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