title: Fetal MRI clues to diagnose cloacal malformations.
abstract: BACKGROUND
  Prenatal US detection of cloacal malformations is challenging and rarely confirms this diagnosis.
  
  
  OBJECTIVE
  To define the prenatal MRI findings in cloacal malformations.
  
  
  METHODS
  We performed a retrospective study of patients with cloacal malformations who had pre- and post-natal assessment at our institution. Fetal MRI was obtained in six singleton pregnancies between 26 and 32 weeks of gestation. Imaging analysis was focused on the distal bowel, the urinary system and the genital tract and compared with postnatal clinical, radiological and surgical diagnoses.
  
  
  RESULTS
  The distal bowel was dilated and did not extend below the bladder in five fetuses. They had a long common cloacal channel (3.5-6 cm) and a rectum located over the bladder base. Only one fetus with a posterior cloacal variant had a normal rectum. Three fetuses had increased T2 signal in the bowel and two increased T1/decreased T2 signal bladder content. All had renal anomalies, four had abnormal bladders and two had hydrocolpos.
  
  
  CONCLUSIONS
  Assessment of the anorectal signal and pelvic anatomy during the third trimester helps to detect cloacal malformations in the fetus. The specificity for this diagnosis was highly increased when bowel fluid or bladder meconium content was identified.
authors.affiliation: Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA. maria.calvo@cchmc.org
authors.forename: Maria A
authors.initials: MA
authors.lastname: Calvo-Garcia
authors.forename: Beth M
authors.initials: BM
authors.lastname: Kline-Fath
authors.forename: Marc A
authors.initials: MA
authors.lastname: Levitt
authors.forename: Foong-Yen
authors.initials: FY
authors.lastname: Lim
authors.forename: Leann E
authors.initials: LE
authors.lastname: Linam
authors.forename: Manish N
authors.initials: MN
authors.lastname: Patel
authors.forename: Steven
authors.initials: S
authors.lastname: Kraus
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Crombleholme
authors.forename: Alberto
authors.initials: A
authors.lastname: Peña
mesh_terms: D002988:Cloaca / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D012189:Retrospective Studies; D014463:Ultrasonography