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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:1563-1568, October 2004
© 2004 American Society of Neuroradiology

PEDIATRICS

Contribution of Fetal MR Imaging in the Evaluation of Cerebral Ischemic Lesions

Catherine Garel^a, Anne-Lise Delezoide^b, Monique Elmaleh-Berges^a, Françoise Menez^b, Catherine Fallet-Bianco^d, Edith Vuillard^c, Dominique Luton^c, Jean-François Oury^c and Guy Sebag^a

^a Department of Pediatric Imaging, Hôpital Robert Debré
^b Department of Developmental Biology, Hôpital Robert Debré
^c Department of Obstetrics and Gynecology, Hôpital Robert Debré
^d Department of Pathology, Hôpital Sainte-Anne, Paris, France

Address reprint requests to Catherine Garel, Department of Pediatric Imaging, Hôpital Robert Debré, 48 Boulevard Sérurier, 75019 Paris, France

BACKGROUND AND PURPOSE: Little is known about the different patterns of fetal cerebral ischemic lesions at MR imaging. Our purpose was to evaluate the contribution of MR imaging in the evaluation of such lesions by correlating the results with ultrasonography (US) and neurofetopathologic (NFP) findings.

METHODS: We examined 28 fetuses (mean, 28 weeks’ gestation) with cerebral ischemic lesions on NFP examination. MR findings were correlated with US and NFP results with regard to the depiction of gyration and parenchymal abnormalities.

RESULTS: MR imaging added to US findings in 24 cases by revealing lesions (gyration abnormalities, parenchymal lesions). These results were either overlooked during US (n = 16) or more extensive than expected with US (n = 8). MR findings were always confirmed by NFP. NFP yielded additional findings for 14 lesions that were overlooked during MR imaging (n = 4) or that were more extensive than expected with MR imaging (n = 10). T1-, T2-, and T2*-weighted MR patterns of different lesions (cavitations, gliosis, softening of the white matter, laminar necrosis, calcified leukomalacia, old hemorrhage) were identified.

CONCLUSION: MR imaging is a valuable tool in the evaluation of fetal brain ischemia. The results of this study emphasize the role of the different sequences (T1-, T2-, T2*-weighted) required to detect fetal cerebral ischemic lesions. MR imaging is more accurate in the detection of small focal lesions than in the evaluation of diffuse white matter abnormalities.

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