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• Clinical Article •
MRI characteristics of fetal intracranial hemorrhage in 120 cases
CHEN Bin  ZHANG Jun 

Cite this article as: Chen B, Zhang J. MRI characteristics of fetal intracranial hemorrhage in 120 cases. Chin J Magn Reson Imaging, 2019, 10(7): 491-496. DOI:10.12015/issn.1674-8034.2019.07.003.


[Abstract] Objective: To analyze prenatal MRI characteristics of fetal intracranial hemorrhage (ICH) and serve it as a reference for antenatal diagnosis and counseling.Materials and Methods: From January 2011 to October 2018, medical records of fetuses with ICH detected by MRI in our institution were successively collected to analyze baseline and MRI characteristics of the condition. Depending on hemorrhagic location, all cases were divided into periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH) group and Non-PVH-IVH group to make a between-group contrast with respect to baseline and MRI appearance. Besides, the association between hemorrhagic characteristics and coexistent intracranial anomalies was explored. Pregnancy and postnatal outcome were also followed up.Results: One hundred and twenty cases were included for analysis. Among them, bleeding onset between late second trimester and early third trimester was common. Periventricular and intraventricular area above tentorial was the common hemorrhagic location (79.17%). Fetal ICH was detected in subacute stage in 80.00% of cases and presented as single hemorrhagic focus in 58.33% of cases. Median of maximal transverse-section area of hemorrhage that can be measured was 238 mm2. The most common intracranial anomaly coexistent with fetal ICH was ventriculomegaly (50.83%). Apart from that, 40.00% of fetal ICH coexisted with other abnormalities. While the proportion of ventriculomegaly was higher in PVH-IVH group than in Non-PVH-IVH group (60.00% vs 16.00%, P<0.001), other anomalies distributed more in the latter group than in the former group (60.00% vs 34.74%, P=0.022). PVH-IVH or not was associated with ventriculomegaly (OR=7.875, 95%CI [2.505, 24.755]) and other intracranial anomalies (OR=0.355, 95%CI [0.114, 0.887]). Among nine cases of livebirth with prenatal ICH, there were seven cases of PVH-IVH and two cases of Non-PVH-IVH. In two cases infant with prenatal grade 1 and grade 2 IVH respectively presented with growth backward and in another case newborn with grade 4 IVH died in a week after birth. Two cases of infants with prenatal non-PVH-IVH did not reveal obvious abnormality during follow up period.Conclusions: Fetal ICH presents prominent characteristics on prenatal MRI. Additional anomalies are not uncommon and its distribution associate with hemorrhagic location. PVH-IVH origins from germinal matrix in most situation and its prognosis can be roughly predicted by IVH grading. The possibility of vascular malformation origin should be aware in Non-PVH-IVH and further research is needed to do to explore its prognosis.
[Keywords] intracranial hemorrhages；fetus；magnetic resonance imaging；prenatal diagnosis

CHEN Bin Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China

ZHANG Jun* Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China

*Correspondence to: Zhang J, E-mail: zhangj1@sj-hospital.org

Conflicts of interest   None.

ACKNOWLEDGMENTS  Key Laboratory Fundamental Research Program of Liaoning Provincial Department of Education No. LS201612
Received  2019-01-20
Accepted  2019-05-25
DOI: 10.12015/issn.1674-8034.2019.07.003
Cite this article as: Chen B, Zhang J. MRI characteristics of fetal intracranial hemorrhage in 120 cases. Chin J Magn Reson Imaging, 2019, 10(7): 491-496. DOI:10.12015/issn.1674-8034.2019.07.003.

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