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Decreased rectal meconium signal on MRI in fetuses with open spinal dysraphism
Author(s) -
Nagaraj Usha D.,
CalvoGarcia Maria A.,
Merrow Arnold C.,
Zhang Bin,
KlineFath Beth M.
Publication year - 2018
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5344
Subject(s) - medicine , meconium , fetus , gestational age , imperforate anus , obstetrics , population , pregnancy , surgery , biology , genetics , environmental health
Abstract Objective To evaluate rectal meconium signal in fetuses with open spinal dysraphism and correlate findings with postnatal exam. Methods This is a single‐institution Institutional Review Board‐approved Health Insurance Portability and Accountability Act (HIPAA) compliant retrospective analysis of fetal MRIs of open spinal dysraphism from 2004 to 2016. Fetuses with diagnostic T1‐weighted images and postnatal follow‐up at our institution were included. Results A total of 115 fetuses (average gestational age 23.9 ± 3.6 weeks) met inclusion criteria. Of these, 80% (92/115) had T1 hyperintense rectal meconium signal. Average height of the meconium column, measured from the base of the bladder to its most inferior extent, was 9.2 ± 4.3 mm in fetuses ≥20‐week gestational age and 11.1 ± 4.4 mm in fetuses ≥23‐week gestational age (n = 110) . None had bowel dilation. One of 115 fetuses had a simple form of anorectal malformation allowing complete repair in the neonatal period, but this fetus had a normal meconium column height on fetal MRI of 22 mm. The remaining 23/115 fetuses with lack of normal rectal meconium signal were born without evidence of anorectal malformation. Conclusion Decreased or absent T1‐hyperintense rectal meconium signal in fetuses with open spinal dysraphism does not correlate with imperforate anus postnatal and may be a reflection of neurogenic bowel in this patient population.