Intracranial hemorrhage and additional anomalies detected on prenatal magnetic resonance imaging: A large, retrospective study in two tertiary medical institutionsAdvances in knowledge

Abstract

Objectives: To clarify the prenatal magnetic resonance (MR) imaging characteristics of fetal intracranial haemorrhages (ICHs) in a large cohort and correlate them with birth outcomes. Methods: We retrospectively reviewed MR images of fetuses with ICH on screening ultrasound (US) on picture archiving communication system (PACS) servers within a nearly ten-year period from two medical tertiary centres. The indications, main abnormal findings and coexistent anomalies were recorded by two experienced radiologists with census readings. Results: We recruited 126 cases (average gestational week, 28.0 ± 5.0 weeks) with prenatal MR imaging, including 116 singleton pregnancies and 10 monochromic twin pregnancies. Predominant coexistent anomalies were ventriculomegaly (35.7 %), holoprosencephaly or porencephaly (13.4 %) and enlarged posterior fossa/or posterior fossa cyst (8.7 %) in the lesion-based evaluation. The number of haemorrhagic lesions and the occurrence of the detected complications did not show a correlation with the size of the haematoma. The mass effect of ICH was more commonly observed in the fetus with large for gestational age (GA) than that with small for GA. Conclusions: Prenatal MR imaging could better show ICH morphology and associated abnormal findings. As a complementary tool of US, MR imaging could help with prenatal counselling and treatment selection after birth.

Keywords

• Fetus
• Magnetic resonance imaging
• Intracranial hemorrhages
• Fetal malformation