Referensi labiopalatoskisis 

Cleft Lip

Jagajan Karmacharya; Arlen D Meyers, MD, MBA 

http://emedicine.medscape.com/article/877970-overview#showall

Role of Fetal MRI in the Evaluation of Labioschisis (LBS) or Labiopalatoschisis (LPS) Isolated or Associated with Syndromic Conditions

Paolo Sollazzo, Presenter, Università "Sapienza" Roma, Policlinico Umberto I

Lucia Manganaro, Abstract Co-Author, University of Rome "La Sapienza"

Alessandra Tomei, Abstract Co-Author, Hospital Umberto I - "Sapienza" University of Rome

Francesca Fierro, Abstract Co-Author, Hospital "Umberto I"

Valeria Vinci, Abstract Co-Author, Policlinico Umberto I

Mario Marini, Abstract Co-Author, University of Rome

PURPOSE

To assess the potential role of fetal MRI in the diagnosis of cleft lip-palate.

METHOD AND MATERIALS

A total of 29 pregnant women with 32 fetuses (29 fetuses evaluated) with a diagnosis of cleft lip-palate determined by prenatal ultrasound were examined using fetal MRI with 1.5-T magnet (Siemens Somatom Avanto) using multiplanar T2-weighted single-shot fast spin-echo sequences and gradient echo with steady-state free precession (SSFP) sequences. Fetal age ranged from 19 to 37 weeks of gestation. We evaluated for each fetus some parameters of cranial and maxillo facial development like anteroposterior diameter of the mandible and the distance between the two rami, interorbital and biorbital diameter, inferior facial angle and fronto-occipital bone diameter. Then we assessed location and extention of the cleft lip, the degree of involvement of palate and defined the presence of associated anomalies. In all cases MRI findings were compared with postnatal US or autoptic findings considered as the standard of reference.

RESULTS

In all fetuses critical anatomic structures of face (orbits, nasal bones, upper lip and palate, chin) were well identified with MRI such as the presence of cleft-lip-palate. In 18 fetuses MRI confirmed the US diagnosis. In the remaining 11 fetuses with positive US examination, the comparison between US and MRI findings revealed a greater detail in 8 cases of lip-palate cleft in the evaluation of hard and soft palate.

In 3 cases MRI disconfirmed/changed the diagnosis or added fetal anomalies missed at US (2 cases with midface anomalies, 1 cleft lip).
 

CONCLUSION

MRI with fast imaging has a crucial role in the recognition of the finest details of normal fetal anatomy. Fetal MRI evaluation is a valuable tool to investigate cleft-lip-palate and facial anomalies, to corroborate US diagnosis and exclude possible associated CNS and non-CNS abnormalities and to plan pregnancy management and pre- or postnatal therapy.

CLINICAL RELEVANCE/APPLICATION

Fetal MRI enables to analyze completely head district, to make an evaluation of facial skeleton biometric development and to precociously detect potential associated pathologies.

http://archive.rsna.org/2011/11011090.html