title: Prenatal diagnosis of bowel malposition using T2-weighted fetal MRI sequences.
abstract: OBJECTIVE
  The goal of this study was to investigate the capability of T2-weighted magnetic resonance imaging (MRI) in revealing fetal bowel malposition.
  
  
  METHODS
  All fetal MRI examinations (excluding central nervous system MRI examinations) performed in our department from January 2005 to January 2014 were retrospectively studied by 2 independent observers for situs, stomach and jejunum location on T2-weighted images. Patients data were also reviewed for results of ultrasound examinations, MRI indication, and gestational age. Abnormally positioned jejunums were classified into 3 groups: intrathoracic (A), extra-fetal (B) and abnormal intra-fetal (C). Prenatal data were compared to postnatal imaging, surgery or autopsy findings that served as standard of reference.
  
  
  RESULTS
  A total of 709 fetal MRI examinations were analyzed. In 64 fetus (9%), the jejunum was not present in the left subgastric area on T2-weighted MR images. In these 64 fetuses, proximal jejunum was intrathoracic (41/64, 64%, group A), extra-fetal (11/64, 17%, group B), or intra-abdominal but abnormally positioned (12/64, 19%, group C). Interobserver agreement was 100%. All diagnoses for fetuses in groups A and B (52 cases) were confirmed postnatally (41 cases) or at autopsy (11 cases). In group C, bowel malposition was suspected after ultrasound in only 2/12 fetuses (16.6%); it was confirmed postnatally in 1 fetus but not confirmed in the remaining one. In the 10 remaining fetuses (83%), malposition was confirmed postnatally although not initially suspected.
  
  
  CONCLUSIONS
  T2-weighted fetal MR images are useful for the prenatal diagnosis of bowel malposition, even when they are unsuspected on ultrasound examination.
authors.affiliation: Service d'imagerie pédiatrique et prénatale, Hôpital Timone Enfants, Marseille, France. Electronic address: melinda.kheiri@ap-hm.fr.
authors.forename: M
authors.initials: M
authors.lastname: Kheiri
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Lesieur
authors.affiliation: Service d'imagerie pédiatrique et prénatale, Hôpital Timone Enfants, Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Dabadie
authors.affiliation: Service d'imagerie pédiatrique et prénatale, Hôpital Timone Enfants, Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Colombani
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Capelle
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Sigaudy
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: B
authors.initials: B
authors.lastname: Guidicelli
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: H
authors.initials: H
authors.lastname: Heckenroth
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Delagausie
authors.affiliation: Service d'imagerie pédiatrique et prénatale, Hôpital Timone Enfants, Marseille, France.
authors.forename: H
authors.initials: H
authors.lastname: Pico
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: N
authors.initials: N
authors.lastname: Philip
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Bretelle
authors.affiliation: Service d'imagerie pédiatrique et prénatale, Hôpital Timone Enfants, Marseille, France; Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Timone Enfants, Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Gorincour
mesh_terms: D005260:Female; D020139:Gastroschisis / Q000000981:diagnostic imaging; D006801:Humans; D007422:Intestines / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies
keywords: Bowel malposition; Fetal MRI; Fetal ultrasound