title: Abnormalities of the upper extremities on fetal magnetic resonance imaging.
abstract: OBJECTIVE
  In view of the increasing use of fetal magnetic resonance imaging (MRI) as an adjunct to prenatal ultrasonography, we sought to demonstrate the visualization of upper extremity abnormalities and associated defects on MRI, with regard to fetal outcomes and compared with ultrasound imaging.
  
  
  METHODS
  This retrospective study included 29 fetuses with upper extremity abnormalities visualized with fetal MRI following suspicious ultrasound findings and confirmed by postnatal assessment or autopsy. On a 1.5-Tesla unit, dedicated sequences were applied to image the extremities. Central nervous system (CNS) and extra-CNS anomalies were assessed to define extremity abnormalities as isolated or as complex, with associated defects. Fetal outcome was identified from medical records. MRI and ultrasound findings, when available, were compared.
  
  
  RESULTS
  Isolated upper extremity abnormalities were found in three (10.3%) fetuses. In 26 (89.7%) fetuses complex abnormalities, including postural extremity disorders (21/26) and structural extremity abnormalities (15/26), were demonstrated. Associated defects involved: face (15/26); musculoskeletal system (14/26); thorax and cardio/pulmonary system (12/26); lower extremities (12/26); brain and skull (10/26); and abdomen (8/26). Of the 29 cases, 18 (62.1%) pregnancies were delivered and 11 (37.9%) were terminated. MRI and US findings were compared in 27/29 cases: the diagnosis was concordant in 14 (51.9%) of these cases, and additional findings were made on MRI in 13/27 (48.1%) cases.
  
  
  CONCLUSIONS
  Visualization of upper extremity abnormalities on fetal MRI enables differentiation between isolated defects and complex ones, which may be related to poor fetal prognosis. MRI generally confirms the ultrasound diagnosis, and may provide additional findings in certain cases.
authors.affiliation: Medical Genetics Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA. stefan.nemec@meduniwien.ac.at
authors.forename: S F
authors.initials: SF
authors.lastname: Nemec
authors.forename: G
authors.initials: G
authors.lastname: Kasprian
authors.forename: P C
authors.initials: PC
authors.lastname: Brugger
authors.forename: D
authors.initials: D
authors.lastname: Bettelheim
authors.forename: G
authors.initials: G
authors.lastname: Amann
authors.forename: U
authors.initials: U
authors.lastname: Nemec
authors.forename: S
authors.initials: S
authors.lastname: Rotmensch
authors.forename: J M
authors.initials: JM
authors.lastname: Graham
authors.forename: D L
authors.initials: DL
authors.lastname: Rimoin
authors.forename: R S
authors.initials: RS
authors.lastname: Lachman
authors.forename: D
authors.initials: D
authors.lastname: Prayer
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000196:embryology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D001699:Biometry; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D034941:Upper Extremity / Q000196:embryology / Q000473:pathology*; D055815:Young Adult