BACKGROUND: Twin-twin transfusion syndrome (TTTS) is a complication of monochorionic/diamniotic twin pregnancies. An imbalance of blood flow occurs through placental anastomoses, causing potentially significant morbidity and mortality in both twins. Although the sonographic findings of TTTS are well documented, we believe that MR imaging is a valuable adjunct. OBJECTIVE: We describe the fetal MR imaging findings associated with TTTS. MATERIALS AND METHODS: From 2003 to 2005, 37 consecutive MR imaging studies were performed on multiple-gestation pregnancies. Of the 37, 25 were consistent with TTTS, correlated and confirmed by sonographic criteria. MR fetal abnormalities were documented. RESULTS: Cerebral ischemia, which could not be demonstrated by sonography, was delineated well by MR imaging. New findings noted on fetal MR imaging were enlargement of cerebral venous sinuses in both twins, dilatation of the renal collecting system in the recipient, lung lesions in the recipient and cerebral malformations in the donor. CONCLUSION: MR imaging is an important adjunct in TTTS imaging. Its benefit over sonography is its clear definition of cerebral pathology, which is important for intervention and counseling. The new findings, particularly in the urinary tract and cerebral venous sinuses, also help support the diagnosis of TTTS and might reveal additional consequences of the altered hemodynamics that occur in TTTS.
BACKGROUND: Twin-twin transfusion syndrome (TTTS) is a complication of monochorionic/diamniotic twin pregnancies. An imbalance of blood flow occurs through placental anastomoses, causing potentially significant morbidity and mortality in both twins. Although the sonographic findings of TTTS are well documented, we believe that MR imaging is a valuable adjunct. OBJECTIVE: We describe the fetal MR imaging findings associated with TTTS. MATERIALS AND METHODS: From 2003 to 2005, 37 consecutive MR imaging studies were performed on multiple-gestation pregnancies. Of the 37, 25 were consistent with TTTS, correlated and confirmed by sonographic criteria. MR fetal abnormalities were documented. RESULTS:Cerebral ischemia, which could not be demonstrated by sonography, was delineated well by MR imaging. New findings noted on fetal MR imaging were enlargement of cerebral venous sinuses in both twins, dilatation of the renal collecting system in the recipient, lung lesions in the recipient and cerebral malformations in the donor. CONCLUSION: MR imaging is an important adjunct in TTTS imaging. Its benefit over sonography is its clear definition of cerebral pathology, which is important for intervention and counseling. The new findings, particularly in the urinary tract and cerebral venous sinuses, also help support the diagnosis of TTTS and might reveal additional consequences of the altered hemodynamics that occur in TTTS.
Authors: H Shinmoto; K Kashima; Y Yuasa; A Tanimoto; Y Morikawa; H Ishimoto; Y Yoshimura; K Hiramatsu Journal: Radiographics Date: 2000 Sep-Oct Impact factor: 5.333
Authors: E M Simon; R B Goldstein; F V Coakley; R A Filly; K C Broderick; T J Musci; A J Barkovich Journal: AJNR Am J Neuroradiol Date: 2000-10 Impact factor: 3.825
Authors: Rudolf Ascherl; Ina Sorge; Ulrich Thome; Franz Wolfgang Hirsch; Annett Bläser; Wieland Kiess; Andreas Merkenschlager Journal: Childs Nerv Syst Date: 2017-10-02 Impact factor: 1.475