MRI of the fetal gastrointestinal tract

Objective: To determine the MRI patterns of the gastrointestinal (GI) tract in normal fetuses and some GI tract abnormalities. Materials and methods: A retrospective (1996-1998) and prospective (1999-2000) study of 48 fetal abdominal MRI scans was performed between 23 and 38 weeks of gestation. T1-weighted (T1-W) fast gradient-echo (Flash 2D) and T2-weighted (T2-W) HASTE sequences were obtained on a 1.5-T unit, in frontal and sagittal planes, after maternal premedication Fresh meconium was also studied. Results: Normal patterns (40 cases): the rectum was seen in all cases and exhibited meconium-like high signal on T1-W images and low signal on T2-W images. It was close to the bladder whatever the fetal gender with its cul-de-sac being at least 10 min below the bladder neck. The large bowel had a same signal; the distal colon was demonstrated more frequently than the proximal colon. The small bowel was transiently hyperintense on T1-W images early in gestation and then hyperintense on T2-W images. Normal measurements were obtained. GI tract abnormalities (eight cases): cysts close to normal bowel (n = 2), atresias (n = 5; microcolon, dilated small bowel with abnormal signal, one with a meconium cyst) and a cloacal malformation with midgut malrotation (n = 1; abnormal liquid signal in the rectum separated from the bladder wall and colon located on the left side). Conclusions: MRI provided complete visualisation of the fetal GI tract, showed specific signal intensities, identified the level of an obstruction, detected a microcolon, and demonstrated communication between urinary and GI tracts. It shows great potential.