The Prenatal Diagnosis of Facial Clefts with Fetal MRI

Abstract

Orofacial clefts are among the most common congenital anomalies caused by abnormal facial development during gestation. As prenatal ultrasonography becomes a routine practice in pregnancy, antenatal detection of facial clefts is possible and improves adequate counseling of the prospective parents and planning of obstetrical and neonatal management. However, the prenatal detection rate, especially of isolated cleft palate, is low. Limitations of ultrasonography include acoustic shadowing from the surrounding structures, poor image quality in case of lack of amniotic fluid or maternal obesity, and limited soft tissue contrast. Fetal MRI is a valuable alternative to ultrasonography providing superior tissue contrast and imaging planes in any orientation regardless of the fetal lie and is increasingly used for detailed assessment of inconclusive sonographic findings. In this article, we describe our experience in evaluating the accuracy of both, prenatal ultrasound and magnetic resonance imaging in detecting the position and extent of a cleft as well as the presence of any associated anomalies.