title: Fetal MRI as a complement to US in the evaluation of cleft lip and palate.
abstract: OBJECTIVE
  The aim of our study was to investigate the role of fetal magnetic resonance imaging (MRI) as a complement to ultrasound (US) in the evaluation of cleft lip and palate (CLP), whether isolated or in association with syndromic conditions.
  
  
  METHODS
  We enrolled 24 pregnant women (27 fetuses) (mean gestational age 23.7 weeks) with a level-two US diagnosis of cleft lip (CL) or CLP with or without associated central nervous system (CNS) or facial-bone anomalies. All individuals underwent a fetal MRI examination to study the facial skeleton, CNS and fetal body. For each fetus, the main anatomical facial landmarks and biometric parameters [anteroposterior diameter (APD), biparietal diameter (BPD), inferior facial angle (IFA), frontomaxillary angle (FMA), bi-orbital diameter (BOD), intraorbital diameter (IOD)] were measured.
  
  
  RESULTS
  Twenty-five of 27 fetuses had a US diagnosis of CL or CLP. MRI confirmed the diagnosis in 16/25 fetuses and added information about the extent of the cleft and the degree of involvement of the anterior and posterior palate in 8/25 fetuses. MRI ruled out the diagnosis in 1/25 fetuses and identified an alteration of the parameters IFA, FMA and IOD in 6/24 fetuses.
  
  
  CONCLUSIONS
  In the study of CLP fetal, MRI is able to define the degree of involvement of the posterior palate and the lateral extent of the cleft with higher diagnostic accuracy than US. Furthermore, MRI provides a complete study of the fetal head and biometric development of the facial bones, thus enabling early detection of potential syndromic conditions.
authors.affiliation: Istituto di Scienze Radiologiche, Policlinico Umberto I, Università degli Studi "Sapienza" Roma, Viale Regina Elena 324, 00161 Roma, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Manganaro
authors.forename: A
authors.initials: A
authors.lastname: Tomei
authors.forename: F
authors.initials: F
authors.lastname: Fierro
authors.forename: M
authors.initials: M
authors.lastname: Di Maurizio
authors.forename: P
authors.initials: P
authors.lastname: Sollazzo
authors.forename: M E
authors.initials: ME
authors.lastname: Sergi
authors.forename: V
authors.initials: V
authors.lastname: Vinci
authors.forename: S
authors.initials: S
authors.lastname: Bernardo
authors.forename: D
authors.initials: D
authors.lastname: Irimia
authors.forename: P
authors.initials: P
authors.lastname: Cascone
authors.forename: M
authors.initials: M
authors.lastname: Marini
mesh_terms: D000328:Adult; D002971:Cleft Lip / Q000000981:diagnostic imaging* / Q000473:pathology*; D002972:Cleft Palate / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal