Clubfeet and associated abnormalities on fetal magnetic resonance imaging.
OBJECTIVE
Clubfoot, or talipes equinovarus (TEV), is commonly diagnosed on prenatal ultrasound. This study sought to visualize TEV and associated abnormalities on fetal magnetic resonance imaging (MRI) compared with ultrasound.


METHODS
This retrospective study included the MRI scans of 44 fetuses with TEV using postnatal assessment and autopsy as standard of reference. Isolated TEV was differentiated from complex TEV with associated abnormalities. MRI findings and previous ultrasound diagnoses were compared.


RESULTS
Isolated TEV was found in 19/44 (43.2%) fetuses and complex TEV in 25/44 (56.8%). Associated abnormalities consisted of the following: central nervous system/spinal abnormalities in 13/25 (52.0%) fetuses; musculoskeletal abnormalities in 7/25 (28.0%); thoracic abnormalities in 3/25 (12.0%); a tumor in one case; and hydrops fetalis in one. Of the 44 cases, 35 (79.5%) pregnancies were delivered, and nine (20.5%) pregnancies, which were terminated, all had complex TEV. Of the 42 available ultrasound reports, additional MRI findings were made in 8/42 (19.0%) cases. MRI did not add findings in isolated TEV on ultrasound. In 4/44 (9.1%) cases, autopsy revealed additional findings compared with prenatal imaging.


CONCLUSIONS
Fetal MRI enables differentiation between isolated and complex TEV. Isolated TEV on ultrasound may not be an MRI indication, whereas MRI may be useful in cases of complex TEV.
Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Vienna, Austria. stefan.nemec@meduniwien.ac.at
Ursula
U
Nemec
Stefan F
SF
Nemec
Gregor
G
Kasprian
Peter C
PC
Brugger
Dieter
D
Bettelheim
Isha
I
Wadhawan
Alexander
A
Kolb
John M
JM
Graham
David L
DL
Rimoin
Daniela
D
Prayer
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging*; D000328:Adult; D002490:Central Nervous System / Q000002:abnormalities; D003025:Clubfoot / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D005333:Fetus / Q000002:abnormalities / Q000000981:diagnostic imaging; D005865:Gestational Age; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal