Fetal MR in the evaluation of pulmonary and digestive system pathology

BACKGROUND: Prenatal awareness of an anomaly ensures better management of the pregnant patient, enables medical teams and parents to prepare for the delivery, and is very useful for making decisions about postnatal treatment. Congenital malformations of the thorax, abdomen, and gastrointestinal tract are common. As various organs can be affected, accurate location and morphological characterization are important for accurate diagnosis. METHODS: Magnetic resonance imaging (MRI) enables excellent discrimination among tissues, making it a useful adjunct to ultrasonography (US) in the study of fetal morphology and pathology. RESULTS: MRI is most useful when US has detected or suspected anomalies, and more anomalies are detected when MRI and US findings are assessed together. CONCLUSION: We describe the normal appearance of fetal thoracic, abdominal, and gastrointestinal structures on MRI, and we discuss the most common anomalies involving these structures and the role of MRI in their study. TEACHING POINTS: • To learn about the normal anatomy of the fetal chest, abdomen, and GI tract on MRI. • To recognize the MR appearance of congenital anomalies of the lungs and the digestive system. • To understand the value of MRI when compared to US in assessing fetal anomalies.