Orit Glenn

MRI is increasingly used to evaluate the fetal brain in cases where an abnormality is detected by routine prenatal sonography and in cases where the fetus is at increased risk for abnormalities in brain development. As such, it allows us to diagnose brain abnormalities in utero that are often missed by prenatal ultrasound.

I chose to study agenesis of the corpus callosum in fetuses using MRI because of my interest in the developing fetal brain and because of the challenges in prenatal counseling of fetal callosal agenesis. I also chose to study this topic because more radiologists are performing fetal MRI, and it is important for us to be familiar with the types of MRI findings that can be seen in fetuses with agenesis of the corpus callosum.

The results of this study have influenced my clinical practice in that I always carefully evaluate the fetal brain for additional abnormalities when callosal agenesis is identified on fetal MRI. In particular, I look carefully for abnormalities of sulcation, brain stem, and cerebellum on fetal MRI. Moreover, this study demonstrates that most of the additional abnormalities detected by fetal MRI in fetuses with callosal agenesis are missed on prenatal ultrasound. The results of this study have also influenced how our

clinicians counsel these patients prenatally. In particular, all fetuses with suspected abnormalities of the corpus callosum are now referred for fetal MRI before they are counseled, as additional abnormalities are frequently detected by fetal MRI, and are usually missed by prenatal ultrasound. Furthermore, prenatal counseling strongly depends on the results of fetal MRI because neurodevelopmental outcome is influenced by whether additional abnormalities are detected.

Overall, fetal MRI continues to be an important tool in the prenatal detection of abnormalities of the fetal brain, whether in callosal agenesis or other suspected brain disorders. In addition to influencing prenatal counseling, fetal MRI provides us with additional insight into the timing and pathogenesis of brain abnormalities. As such, our research on fetal MRI in fetal callosal agenesis and other brain disorders continues.

Read this article at AJNR.org …