A clearer picture: Using fetal MRI to diagnose neck masses and predict airway compromise

Introduction

Fetal neck masses are rare but can be life-threatening if causing airway compromise. Early and accurate diagnosis of these masses allows life-saving interventions to be undertaken at birth in the form of the EXIT procedure.

Methods

A single institution case series of all patients referred for fetal MRI to a tertiary center in the North of England due to presence of a neck mass on antenatal ultrasound. Data concerning the MRI findings for each patient and their final diagnosis were collected to create a flow chart proposing the most likely diagnosis based on fetal MRI features.

Results

13 patients who underwent fetal MRI for a neck mass with a final diagnosis available were included in the analysis. This review shows the range of diagnoses in these patients and that MRI was accurate in predicting airway compression and the need for the EXIT procedure.

Conclusion

Fetal MRI is a valuable tool in addition to ultrasound for refining the diagnosis of masses of the fetal neck and assessment of airway patency to allow planning for management at birth.

Summary

What's already known about this topic?

Early diagnosis of fetal neck masses is important for antenatal counselling and for planning management at birth.

What does this study add?

Use of fetal MRI allows refinement of the diagnosis and accurate assessment of airway patency prior to birth.