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Right congenital diaphragmatic hernia

Case Study
Kline-Fath, Beth, M.D. Cincinnati Children's Hospital Medical Center • USA
Serai, Suraj, Ph.D. Cincinnati Children's Hospital Medical Center • USA

Patient history

A 22-year-old pregnant woman with a fetus at 33 weeks being evaluated for fetal lung lesion.

MR examination

MRI was done on Ingenia 1.5T. With the mother on her side – one digital Anterior coil on her back and another one on her front are used. These two coils used together with the Posterior coil integrated in the table, cover the patient on all sides.


View ExamCard used:

Images

 T2 SSh TSE cor T2 SSh TSE axial
T2 SSh TSE cor
T2 SSh TSE axial

The coronal T2-weighted SSh TSE image demonstrates a fluid filled small bowel (long arrow) and dark meconium filled colon (short arrow) in the left chest confirming presence of congenital diaphragmatic hernia. Note the normal location of stomach (dotted arrow) in the left upper abdomen.
 
The axial SSh TSE T2-weighted image again shows small bowel (long arrow) and meconium (short arrow) in the right chest. The heart (dotted arrow) is displaced into the left chest.
 

Diagnosis

The findings led to counseling and preparation for respiratory support at delivery.

Clinical impact of using Ingenia 1.5T

A difficulty in fetal MRI is that imaging the mother requires a large field of view, but the fetus is very small and embedded deep inside the mother, so SNR is inherently low. The key is to maximize SNR. That can be done using Ingenia with its digital architecture. Because the signal is digitized directly in the coil, it helps to obtain high SNR. This coil setup used at Cinicinnati Children's offers big advantages. When the fetus moves, no repositioning of the coil is needed. The field of view can just be moved, the coil elements are already there and Ingenia’s SmartSelect automatically chooses the elements to obtain the best possible SNR. Ingenia’s wide bore is another advantage; with pregnant patients, it really makes a difference.

Ingenia’s strong gradients allow to set up fast imaging and that helps reduce fetal motion that can influence the scan. The gradients also help to reduce the TR and TE for high quality in the Balanced SSFP images. High SNR, digital coil setup and wide bore contribute to a smart approach for fetal MR imaging at Cincinnati Children’s Hospital.


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Nov 28, 2013

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Case Study
Ingenia 1.5T
Anterior coil, Body, dStream, Fetal, Pediatric, Posterior coil, Women's health
 

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