Fetal magnetic resonance imaging of lymphangiomas
-
Claus Koelblinger
,
Christian Herold
Abstract
Objectives: To evaluate the fetal magnetic resonance imaging findings of lymphangiomas.
Methods: The magnetic resonance scans of eight fetuses with lymphangiomas were evaluated. Magnetic resonance evaluation included: number; size; signal intensities of the lesions; thickness of the septae; configuration of the margins; presence of blood breakdown products; change in size or signal intensity (in four patients with multiple examinations); exact expansion of the lesions to the adjacent anatomical structures; and concomitant pathological findings. Results were compared with postpartum clinical assessment and imaging in seven patients and with autopsy in one patient.
Results: Two retroperitoneal, three thoracic, and three cervical lymphangiomas (diameters between 3.3 and 15.6 cm) were included. All lesions consisted of macrocysts, and additional microcystic parts were found in three lymphangiomas. Blood breakdown products were found in one lesion. Agreement with postpartum imaging was excellent. One patient received intrauterine drainage for chylothorax, and one pregnancy was terminated.
Conclusions: Fetal lymphangiomas display the same magnetic resonance imaging features as postnatal lymphangiomas. Intrauterine magnetic resonance characterization of lymphangiomas provides the exact delineation, detection of associated and/or concomitant pathologies, and differential diagnosis among other cystic pathologies. Patient management may be altered with respect to the type and/or time of treatment, and with regard to the continuation or termination of pregnancy.
References
[1] Blei F. Congenital lymphatic malformations. Ann N Y Acad Sci. 2008;1131:185–94.10.1196/annals.1413.016Search in Google Scholar
[2] Bond SJ, Harrison MR, Schmidt KG, Silverman NH, Flake AW, Slotnick RN, et al. Death due to high-output cardiac failure in fetal sacrococcygeal teratoma. J Pediatr Surg. 1990; 25:1287–91.10.1016/0022-3468(90)90535-HSearch in Google Scholar
[3] Breysem L, Bosmans H, Dymarkowski S, Schoubroeck DV, Witters I, Deprest J, et al. The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis. Eur Radiol. 2003;13:1538–48.10.1007/s00330-002-1811-6Search in Google Scholar PubMed
[4] Chen CP. Prenatal imaging of the fetal anterior chest wall cystic hygroma by magnetic resonance imaging. Prenat Diagn. 2003;23:1099–100.10.1002/pd.755Search in Google Scholar PubMed
[5] Cozzi DA, Olivieri C, Manganaro F, Savelli S, Giancotti A, Manganaro L. Fetal abdominal lymphangioma enhanced by ultrafast MRI. Fetal Diagn Ther. 2010;27:46–50.10.1159/000262282Search in Google Scholar PubMed
[6] Deshpande P, Twining P, O’Neill D. Prenatal diagnosis of fetal abdominal lymphangioma by ultrasonography. Ultrasound Obstet Gynecol. 2001;17:445–8.10.1046/j.1469-0705.2001.00367.xSearch in Google Scholar PubMed
[7] Hubbard AM, Crombleholme TM, Adzick NS. Prenatal MRI evaluation of giant neck masses in preparation for the fetal exit procedure. Am J Perinatol. 1998;15:253–7.10.1055/s-2007-993937Search in Google Scholar PubMed
[8] Kaminopetros P, Jauniaux E, Kane P, Weston M, Nicolaides KH, Campbell DJ. Prenatal diagnosis of an extensive fetal lymphangioma using ultrasonography, magnetic resonance imaging and cytology. Br J Radiol. 1997;70:750–3.10.1259/bjr.70.835.9245887Search in Google Scholar PubMed
[9] Kathary N, Bulas DI, Newman KD, Schonberg RL. MRI imaging of fetal neck masses with airway compromise: utility in delivery planning. Pediatr Radiol. 2001;31:727–31.10.1007/s002470100527Search in Google Scholar PubMed
[10] Malnofski MJ, Poulton TB, Nazinitsky KJ, Hissong SL. Prenatal ultrasonic diagnosis of retroperitoneal cystic lymphangioma. J Ultrasound Med. 1993;12:427–9.10.7863/jum.1993.12.7.427Search in Google Scholar PubMed
[11] Marchese C, Savin E, Dragone E, Carozzi F, De Marchi M, Campogrande M, et al. Cystic hygroma: prenatal diagnosis and genetic counselling. Prenat Diagn. 1985;5:221–7.10.1002/pd.1970050310Search in Google Scholar PubMed
[12] Mittermayer C, Brugger PC, Lee A, Horcher E, Hayde M, Bernaschek G, et al. Prenatal magnetic resonance imaging as a useful adjunctive to ultrasound-enhanced diagnosis in case of a giant foetal tumour of the neck. Ultraschall Med. 2005;26:46–50.10.1055/s-2005-857947Search in Google Scholar PubMed
[13] Nakayama T, Yoshimitsu K, Irie H, Aibe H, Tajima T, Nishie A, et al. Diffusion-weighted echo-planar MR imaging and ADC mapping in the differential diagnosis of ovarian cystic masses: usefulness of detecting keratinoid substances in mature cystic teratomas. J Magn Reson Imaging. 2005;22:271–8.10.1002/jmri.20369Search in Google Scholar PubMed
[14] Ogita K, Suita S, Taguchi T, Yamanouchi T, Masumoto K, Tsukimori K, et al. Outcome of fetal cystic hygroma and experience of intrauterine treatment. Fetal Diagn Ther. 2001;16:105–10.10.1159/000053891Search in Google Scholar PubMed
[15] Ogura T, Hamada H, Obata-Yasuoka M, Watanabe H, Okuno S, Fujiki Y, et al. Antepartum assessment of fetal cystic lymphangioma by magnetic resonance imaging. Gynecol Obstet Invest. 2002;53:237–9.10.1159/000064563Search in Google Scholar PubMed
[16] Okazaki T, Iwatani S, Yanai T, Kobayashi H, Kato Y, Marusasa T, et al. Treatment of lymphangioma in children: our experience of 128 cases. J Pediatr Surg. 2007;42:386–9.10.1016/j.jpedsurg.2006.10.012Search in Google Scholar PubMed
[17] Paladini D, Vassallo M, Sglavo G, Lapadula C, Longo M, Nappi C. Cavernous lymphangioma of the face and neck: prenatal diagnosis by three-dimensional ultrasound. Ultrasound Obstet Gynecol. 2005;26:300–2.10.1002/uog.1972Search in Google Scholar PubMed
[18] Prayer D, Brugger PC. Investigation of normal organ development with fetal MRI. Eur Radiol. 2007; 17:2458–71.10.1007/s00330-007-0604-3Search in Google Scholar PubMed
[19] Rasidaki M, Sifakis S, Vardaki E, Koumantakis E. Prenatal diagnosis of a fetal chest wall cystic lymphangioma using ultrasonography and MRI: a case report with literature review. Fetal Diagn Ther. 2005;20:504–7.10.1159/000088039Search in Google Scholar PubMed
[20] Rha SE, Byun JY, Kim HH, Shin JC, Ahn HY, Kim DC, et al. Prenatal sonographic and MR imaging findings of extensive fetal lymphangioma: a case report. Korean J Radiol. 2003;4:260–3.10.3348/kjr.2003.4.4.260Search in Google Scholar PubMed PubMed Central
[21] Siegel MJ, Glazer HS, St Amour TE, Rosenthal DD. Lymphangiomas in children: MR imaging. Radiology. 1989;170:467–70.10.1148/radiology.170.2.2911671Search in Google Scholar PubMed
[22] Teksam M, Ozyer U, McKinney A, Kirbas I. MR imaging and ultrasound of fetal cervical cystic lymphangioma: utility in antepartum treatment planning. Diagn Interv Radiol. 2005;11:87–9.Search in Google Scholar
[23] Wunderbaldinger P, Paya K, Partik B, Turetschek K, Hormann M, Horcher E, et al. CT and MR imaging of generalized cystic lymphangiomatosis in pediatric patients. AJR Am J Roentgenol. 2000;174:827–32.10.2214/ajr.174.3.1740827Search in Google Scholar PubMed
[24] Zadvinskis DP, Benson MT, Kerr HH, Mancuso AA, Cacciarelli AA, Madrazo BL, et al. Congenital malformations of the cervicothoracic lymphatic system: embryology and pathogenesis. Radiographics. 1992;12:1175–89.10.1148/radiographics.12.6.1439020Search in Google Scholar PubMed
The authors stated that there are no conflicts of interest regarding the publication of this article.
©2013 by Walter de Gruyter Berlin Boston
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Articles in the same Issue
- Masthead
- Masthead
- Review article
- Anxious and depressive components of Edinburgh Postnatal Depression Scale in maternal postpartum psychological problems1)
- Original Articles – Obstetrics
- Isolated low-normal amniotic fluid volume in the early third trimester: association with adverse perinatal outcomesa
- Trends in twin pregnancies and mode of delivery during the last 30 years: inconsistency between guidelines and clinical practice
- Prenatal care in adult women exposed to childhood sexual abuse
- Maternal and fetal adropin levels in gestational diabetes mellitus
- Ethnic disparities in perinatal mortality at 40 and 41 weeks of gestation
- Polymorphisms in the activin A receptor type 2A gene affect the onset time and severity of preeclampsia in the Turkish population
- Outcome of isolated fetal renal pyelectasis diagnosed during midtrimester screening ultrasound and cut-off value to predict a persistent or progressive pyelectasis in utero
- A polymorphism in an autophagy-related gene, ATG16L1, influences time to delivery in women with an unfavorable cervix who require labor induction
- Management of gestational hypertension – the impact of HYPITATa
- Reliability of quantitative elastography of the uterine cervix in at-term pregnancies
- Congenital anomalies, prematurity, and low birth weight rates in relation to nuclear power plant proximity1)
- Original Articles – Fetus
- Fetal magnetic resonance imaging of lymphangiomas
- Original Articles – Newborn
- Brainstem dysgenesis during the neonatal period: diagnosis and management
- Improving admission temperature in extremely low birth weight infants: a hospital-based multi-intervention quality improvement project
- Short Communication
- Periconceptional use of folic acid and risk of miscarriage – findings of the Oral Cleft Prevention Program in Brazil
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