Antenatal magnetic resonance imaging is useful in providing predictive values for surgical procedures in abdominal wall defects.
BACKGROUND
Antenatal magnetic resonance imaging (MRI) is useful for the diagnosis of abdominal wall defects. Its predictive value concerning the possibility of primary closure of the abdominal wall, however, has so far not been reported.


METHODS
Between August 2001 and November 2004, antenatal MRI was performed on 9 patients with abdominal wall defects in whom surgical repair was performed immediately after birth. Areas of the abdominal cavity and exteriorized viscera were manually traced from both sagittal and axial MR images, and the data were further transmitted to a Workstation for MRI Volumetry (Advantage Windows 4.1, General Electric Medical Systems, Milwaukee, Wis). We examined the exteriorized ratio (ER), which is calculated by dividing the absolute volume of the abdominal cavity by that of the exteriorized viscera, and evaluated the predictive value by a retrospective comparison with surgical procedure.


RESULTS
In the primary closure group (n = 5), mean values of ER were 0.33 +/- 0.31 from axial and 0.45 +/- 0.31 from sagittal MR images. In contrast, in the staged closure group (n = 4), mean values of ER were 1.39 +/- 0.40 from axial and 1.34 +/- 0.42 from sagittal MR images. There was a significant difference (P < .05) between the 2 groups for both sets of images. The ER obtained from antenatal MRI correlated well with surgical procedure.


CONCLUSIONS
The ER might be useful for antenatal counseling, planning for delivery, and prediction of the most likely surgical procedure.
Takada
Kohei
K
Division of Pediatric Surgery, Kansai Medical University, Hirakata City, Osaka 573-1192, Japan. takadako@hirakata.kmu.ac.jp
Hamada
Yoshinori
Y
Watanabe
Kentaro
K
Tanano
Akihide
A
Tokuhara
Katsuji
K
Sato
Masahito
M
Kamiyama
Yasuo
Y
D034861:Abdominal Wall / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D046449:Hernia, Abdominal / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D016896:Treatment Outcome