Introduction Fetal magnetic resonance imaging (MRI) is a modality that is becoming more frequently used to evaluate a fetus with suspected anomalies. There are very few data about ocular growth and abnormalities as seen with fetal MRI. This is the first report of isolated microphthalmia diagnosed by fetal MRI. We also compare eye measurements in the affected fetus with others of similar gestational age who had morphologically normal brains and eyes on fetal MRI.
Methods Retrospective review of the MR images of fetuses at 21 to 23 weeks' gestation at our institution who were identified to have structurally normal brains and eyes were used as controls (N = 13) to compare with our patient. Using a 1.5-Tesla magnet, a body coil was placed over the mother's abdomen and multiple single-shot T2 fast spin echo images were obtained using 3 mm collimation. The images were of axial, sagittal, and coronal planes of the fetus. Quantitative measurements were performed on a Synapse PACS. The average transverse diameter of each globe, intraocular distance, lens diameters, and calculated globe volumes of the control were compared with the index case.
Results The transverse globe diameters for the index patient were 2.2 and 2.5 mm (right and left, respectively) compared with 10.5 mm in the control patients. The intraocular distance was 10.8 mm versus an average of 12.5 mm in the other patients of similar gestational age. The lenses were not visible on the index patient. The globe volume for the index patient was 8.9 and 10.5 mm3 (right and left, respectively) compared with 520 mm3 and 534 mm3.
Conclusions Abnormal fetal eye size, including the condition of microphthalmia, can be identified with fetal MRI. In fetuses with suspected eye abnormalities, fetal MRI is an imaging modality that should be considered to further evaluate globe and orbit structures. For fetuses who receive MRI for nonocular abnormalities, we recommend examining the eye images as abnormalities may be readily apparent.
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