Abstract
In this paper the authors review the normal imaging appearance of the fetal gastrointestinal tract and patterns of fetal gastrointestinal tract obstruction. The authors include a detailed summary from esophagus to the rectum, including the expected pattern of meconium and small-bowel contents at different gestational ages. Common fetal gastrointestinal tract obstructions are reviewed with accompanying case examples, emphasizing the role of the meconium and bowel-caliber patterns in establishing differential diagnoses. This review also includes imaging pitfalls, complications of gastrointestinal tract obstruction, and implications for patient care.
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References
Huisman TA, Kellenberger CJ (2008) MR imaging characteristics of the normal fetal gastrointestinal tract and abdomen. Eur J Radiol 65:170–181
Brugger PC, Prayer D (2006) Fetal abdominal magnetic resonance imaging. Eur J Radiol 57:278–293
Righetti C, Peroni DG, Pietrobelli A, Zancanaro C (2003) Proton nuclear magnetic resonance analysis of meconium composition in newborns. J Pediatr Gastroenterol Nutr 36:498–501
Furey EA, Bailey AA, Twickler DM (2016) Fetal MR imaging of gastrointestinal abnormalities. Radiographics 36:904–917
Malas MA, Aslankoc R, Ungor B et al (2004) The development of large intestine during the fetal period. Early Hum Dev 78:1–13
Brugger PC, Mittermayer C, Herold CJ et al (2005) Virtual colonography of the fetal colon. Eur Radiol 15:B-892
Saguintaah M, Couture A, Veyrac C et al (2002) MRI of the fetal gastrointestinal tract. Pediatr Radiol 32:395–404
Rubio EI, Blask AR, Badillo AT, Bulas DI (2017) Prenatal magnetic resonance and ultrasonographic findings in small-bowel obstruction: imaging clues and postnatal outcomes. Pediatr Radiol 47:411–421
Garabedian C, Verpillat P, Czerkiewicz I et al (2014) Does a combination of ultrasound, MRI, and biochemical amniotic fluid analysis improve prenatal diagnosis of esophageal atresia? Prenat Diagn 34:839–842
Best KE, Tennant PW, Addor MC et al (2012) Epidemiology of small intestinal atresia in Europe: a register-based study. Arch Dis Child Fetal Neonatal Ed 97:F353–F358
D'Amico A, Buca D, Rizzo G et al (2020) Outcome of fetal echogenic bowel: a systematic review and meta-analysis. Prenat Diagn. https://doi.org/10.1002/pd.5638
Gunderman P, Shea L, Gray B, Brown BP (2018) Fetal MRI in management of complicated meconium ileus: prenatal and surgical imaging. Prenat Diagn 38:685–691
Veyrac C, Couture A, Saguintaah M, Baud C (2004) MRI of fetal GI tract abnormalities. Abdom Imaging 29:411–420
Ballisty MM, Braithwaite KA, Shehata BM, Dickson PN (2013) Imaging findings in megacystis-microcolon-intestinal hypoperistalsis syndrome. Pediatr Radiol 43:454–459
Stoll C, Alembik Y, Roth MP, Dott B (1997) Risk factors in congenital anal atresias. Ann Genet 40:197–204
Cuschieri A, EUROCAT Working Group (2002) Anorectal anomalies associated with or as part of other anomalies. Am J Med Genet 110:122–130
Lau PE, Cruz S, Cassady CI et al (2017) Prenatal diagnosis and outcome of fetal gastrointestinal obstruction. J Pediatr Surg 52:722–725
Stoll C, Alembik Y, Dott B, Roth MP (1996) Evaluation of prenatal diagnosis of congenital gastro-intestinal atresias. Eur J Epidemiol 12:611–616
Jerdee T, Newman B, Rubesova E (2015) Meconium in perinatal imaging: associations and clinical significance. Semin Ultrasound CT MR 36:161–177
Lubusky M, Prochazka M, Dhaifalah I (2006) Fetal enterolithiasis: prenatal sonographic and MRI diagnosis in two cases of urorectal septum malformation (URSM) sequence. Prenat Diagn 26:345–349
Nagaraj UD, Calvo-Garcia MA, Merrow AC et al (2018) Decreased rectal meconium signal on MRI in fetuses with open spinal dysraphism. Prenat Diagn 38:870–875
Kawamura T, Nishiguchi T (2017) Congenital chloride diarrhea (CCD): a case report of CCD suspected by prenatal ultrasonography and magnetic resonance imaging (MRI). Am J Case Rep 18:707–713
Rubesova E (2012) Fetal bowel anomalies — US and MR assessment. Pediatr Radiol 42:S101–S106
Caro-Domínguez P, Zani A, Chitayat D, Daneman A (2018) Meconium peritonitis: the role of postnatal radiographic and sonographic findings in predicting the need for surgery. Pediatr Radiol 48:1755–1762
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Marine, M.B., Forbes-Amrhein, M.M. Magnetic resonance imaging of the fetal gastrointestinal system. Pediatr Radiol 50, 1895–1906 (2020). https://doi.org/10.1007/s00247-020-04677-2
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DOI: https://doi.org/10.1007/s00247-020-04677-2