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Ultraschall Med 2005; 26(1): 46-50
DOI: 10.1055/s-2005-857947
Case Report

© Georg Thieme Verlag Stuttgart · New York

Prenatal Magnetic Resonance Imaging as a Useful Adjunctive to Ultrasound-Enhanced Diagnosis in Case of a Giant Foetal Tumour of the Neck

Pränatale Magnetresonanztomographie als wichtige Hilfestellung zum pränatalen US beim Vorliegen eines großen fetalen HalstumorsC.  Mittermayer1 , P. C.   Brugger3 , A.  Lee2 , E.  Horcher4 , M.  Hayde1 , G.  Bernaschek2 , D.  Prayer3
  • 1Department of Neonatology and Intensive Care, of the University Hospital Vienna
  • 2Department of Obstetrics and Gynaecology, Division of Prenatal Diagnosis and Therapy of the University Hospital Vienna
  • 3Department of Radiology, Division of Neuroradiology of the University Hospital Vienna
  • 4Department of Surgery, Division of Child Surgery of the University Hospital Vienna
Further Information

Publication History

received: 10.2.2003

accepted: 13.8.2003

Publication Date:
07 February 2005 (online)

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Zusammenfassung

Die Diagnose von großen Halstumoren in der pränatalen Diagnostik ist selten. Für den Pädiater ist sie aber unerlässlich, da lebensbedrohliche Situationen unmittelbar post partum durch diese Tumoren verursacht werden. Ein fetaler Halstumor wurde mittels Ultraschall, bei einer 41-jährigen Frau, gravida 4 para 3, mit 29 + 5 Schwangerschaftswochen diagnostiziert. Aufgrund der Sonomorphologie handelte es sich am ehesten um ein fetales Teratom, über die genaue Anatomie von Oropharynx und Trachea konnte im Ultraschall keine Aussage gemacht werden. Eine MRT-Untersuchung zeigte eine Verdrängung der Trachea nach rechts hinten und im proximalen Drittel nicht darstellbar. Der Oropharynx fand sich, durch eine nach proximal verdrängte Zunge, komprimiert. Basierend auf diesen Befunden wurde als Entbindungsmodus die EXIT-Prozedur gewählt. Eine fetale Magnetresonanztomographie ist in manchen Fällen eine wertvolle zusätzliche Hilfe in der pränatalen Diagnostik, um fetale anatomische Strukturen darzustellen. Sie kann wichtige patho-anatomische Informationen liefern, die das Management der Schwangerschaft beeinflussen können.

Abstract

Large cervical masses in the prenatal period are rare and can cause life threatening situations after birth. All available diagnostic techniques should therefore be used to determine the best mode of delivery in the case of such malformation. A large cervical mass was detected by ultrasound in a 41-year-old women, gravida 4, para 3, at 29 + 5 weeks of gestation. US imaging was most consistent with the diagnosis of a large cervical teratoma, but it was not possible to sufficiently evaluate the cervical anatomy of the oropharynx and trachea. An MRI scan demonstrated a distorted oropharynx and a trachea displaced to the right and posteriorly, but not detectable from the middle of the neck up to the larynx. Based on these facts, an EXIT procedure was planned and performed at 30 + 5 weeks of gestation. Foetal MRI provided valuable anatomical information for all specialists deciding on the indication and the pre-therapeutic planning of the EXIT procedure.

Schlüsselwörter

Fetales MRT - Halstumor - pränatale Diagnostik - Ultraschall - EXIT-Prozedur

Key words

Fetal MRI - foetal neck mass - prenatal diagnosis - ultrasound - EXIT procedure

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MD C. Mittermayer

Department of Neonatology and Intensive Care · University Hospital Vienna

Währinger Gürtel 18-20 · 1090 Vienna · Austria ·

Phone: +43 1 40400 5572

Fax: +43 1 40400 3296

Email: christoph.mittermayer@akh.gyn.magwien.gv.at