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Prenatal and postnatal MRI findings in open spinal dysraphism following intrauterine repair via open versus fetoscopic surgical techniques
Author(s) -
Nagaraj Usha D.,
Bierbrauer Karin S.,
Stevenson Charles B.,
Peiro Jose L.,
Lim Foong Yen,
Habli Mounira A.,
KlineFath Beth M.
Publication year - 2020
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.5540
Subject(s) - medicine , fetal surgery , surgery , fetoscopy , gestational age , hysterotomy , prenatal diagnosis , pregnancy , fetus , in utero , genetics , biology
Purpose The purpose of the study is to examine MRI findings of the brain and spine on prenatal and postnatal MRI following intrauterine repair of open spinal dysraphism (OSD) by open hysterotomy and fetoscopic approaches. Materials and methods This study is a single‐center HIPAA‐compliant and IRB‐approved retrospective analysis of fetal MRIs with open spinal dysraphism from January 2011 through December 2018 that underwent subsequent prenatal repair of OSD. Results Sixty‐two patients met inclusion criteria: 47 underwent open repair, and 15 underwent fetoscopic repair, with an average gestational age of 22.6 ± 1.4 weeks at initial MRI. On postnatal MRI, spinal cord syrinx was seen in 34% (16/47) of patients undergoing open versus 33.3% (5/15) undergoing fetoscopic repair ( P = 0.96). Postnatally, there was no significant difference in hindbrain herniation between the open versus fetoscopic repair groups ( P = 0.28). Lateral ventricular size was significantly larger in the open (20.9 ± 6.7 mm) versus the fetoscopic repair (16.1 ± 4.9 mm) group ( P = 0.01). Conclusion Though lateral ventricular size in the open repair group was larger than the fetoscopic repair group, this can likely be explained by initial selection criteria used for fetoscopic repair. Other postoperative imaging parameters on postnatal MRI were not significantly different between the two groups.