A Case Study: Maxillofacial MRI of a Fetal with a Complaint of Narrowing of the Upper Alveolar Process

Abstract

Purpose

Tooth buds anomalies coincide with genetic disorders, and prenatal identification may contribute to a more accurate diagnosis. And fetal cleft lip and palate (CLP) is a common congenital facial malformation, which not only affects the appearance of children but also causes malnutrition in children with the difficulty of sucking milk. The purpose of the presentation was to improve the feasibility of fetal magnetic resonance imaging in visualizing intrauterine tooth buds alignment, CLP conditions and image quality.

Method

A 29-year-old pregnant woman was referred to our institution with an ultrasound report of a narrow upper alveolar process. We used 3.0T MRI Steady-State-Free-Precession (bSSFP) and Single-Shot Fast Spin-Echo (SS-FSE) sequences to examine this fetus for tooth bud abnormalities and CLP. Sagittal scanning is performed with the fetus swallowing amniotic fluid so that the tongue and palate are separated to better show the continuity of the hard and soft palate. The oblique axial position is scanned along the sagittal superior alveolar process to show the development of the tooth buds.

Result

Compared to the SS-FSE sequence, bSSFP sequence improves the SNR and contrast, and better shows the alignment of the tooth buds as well as the palate. It was finally confirmed that the fetus had a narrow upper alveolar eminence for abnormal tooth buds alignment (deciduous central incisor teeth, lateral incisor teeth and cusp incisors)and that there was no CLP.

Conclusion

The use of the bSSFP sequence to better shows fetal maxillofacial structures in the presence of amniotic fluid swallowing, also improves diagnostic accuracy and the diagnosis of associated syndromes.