Reversible parenchymal ischemic injury on fetal brain MRI following fetoscopic laser coagulation—Implication on parental counseling
We present a case of reversible extensive ischemic injury seen on fetal-brain MRI in a fetus following laser coagulation performed for treatment of severe twin-twin transfusion syndrome twin-twin transfusion syndrome. A 32-year-old pregnant mother presented with twin-twin transfusion syndrome. Follo...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-08-01
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| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043320302521 |
| _version_ | 1818414969351307264 |
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| author | Shai Shrot, MD Chen Hoffmann, MD Eldad Katorza, MD |
| author_facet | Shai Shrot, MD Chen Hoffmann, MD Eldad Katorza, MD |
| author_sort | Shai Shrot, MD |
| collection | DOAJ |
| description | We present a case of reversible extensive ischemic injury seen on fetal-brain MRI in a fetus following laser coagulation performed for treatment of severe twin-twin transfusion syndrome twin-twin transfusion syndrome. A 32-year-old pregnant mother presented with twin-twin transfusion syndrome. Following fetoscopic laser coagulation, intrauterine fetal death of the donor fetus was diagnosed. On fetal-brain MRI, multiple areas of restricted diffusion were noted, consistent with acute infarctions. Nevertheless, follow-up MRI showed only subtle parenchymal injury, also confirmed on postnatal brain MRI. Our case illustrates that ischemic injury, as depicted on diffusion-weighted imaging, might be reversible, possibly with reperfusion before irreversible insult follows. Two to 3 weeks follow-up fetal MRI might provide additional information on the extent of irreversible injury in cases of restricted diffusion seen on initial fetal-brain MRI and might assist in parental counseling regarding long-term sequela. |
| first_indexed | 2024-12-14T11:27:32Z |
| format | Article |
| id | doaj.art-ea78923ba5e54640b508b63b282c3a30 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-12-14T11:27:32Z |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-ea78923ba5e54640b508b63b282c3a302022-12-21T23:03:28ZengElsevierRadiology Case Reports1930-04332020-08-0115813691372Reversible parenchymal ischemic injury on fetal brain MRI following fetoscopic laser coagulation—Implication on parental counselingShai Shrot, MD0Chen Hoffmann, MD1Eldad Katorza, MD2Section of Neuroradiology, Department of Diagnostic Imaging, Sheba Medical Center, Ramat-Gan, Israel, 2 Sheba Rd, Ramat-Gan 52621, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Corresponding author.Section of Neuroradiology, Department of Diagnostic Imaging, Sheba Medical Center, Ramat-Gan, Israel, 2 Sheba Rd, Ramat-Gan 52621, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, IsraelWe present a case of reversible extensive ischemic injury seen on fetal-brain MRI in a fetus following laser coagulation performed for treatment of severe twin-twin transfusion syndrome twin-twin transfusion syndrome. A 32-year-old pregnant mother presented with twin-twin transfusion syndrome. Following fetoscopic laser coagulation, intrauterine fetal death of the donor fetus was diagnosed. On fetal-brain MRI, multiple areas of restricted diffusion were noted, consistent with acute infarctions. Nevertheless, follow-up MRI showed only subtle parenchymal injury, also confirmed on postnatal brain MRI. Our case illustrates that ischemic injury, as depicted on diffusion-weighted imaging, might be reversible, possibly with reperfusion before irreversible insult follows. Two to 3 weeks follow-up fetal MRI might provide additional information on the extent of irreversible injury in cases of restricted diffusion seen on initial fetal-brain MRI and might assist in parental counseling regarding long-term sequela.http://www.sciencedirect.com/science/article/pii/S1930043320302521IschemiaTTTSFetal MRIDiffusion weighted imagingIUFDObstetrics |
| spellingShingle | Shai Shrot, MD Chen Hoffmann, MD Eldad Katorza, MD Reversible parenchymal ischemic injury on fetal brain MRI following fetoscopic laser coagulation—Implication on parental counseling Radiology Case Reports Ischemia TTTS Fetal MRI Diffusion weighted imaging IUFD Obstetrics |
| title | Reversible parenchymal ischemic injury on fetal brain MRI following fetoscopic laser coagulation—Implication on parental counseling |
| title_full | Reversible parenchymal ischemic injury on fetal brain MRI following fetoscopic laser coagulation—Implication on parental counseling |
| title_fullStr | Reversible parenchymal ischemic injury on fetal brain MRI following fetoscopic laser coagulation—Implication on parental counseling |
| title_full_unstemmed | Reversible parenchymal ischemic injury on fetal brain MRI following fetoscopic laser coagulation—Implication on parental counseling |
| title_short | Reversible parenchymal ischemic injury on fetal brain MRI following fetoscopic laser coagulation—Implication on parental counseling |
| title_sort | reversible parenchymal ischemic injury on fetal brain mri following fetoscopic laser coagulation implication on parental counseling |
| topic | Ischemia TTTS Fetal MRI Diffusion weighted imaging IUFD Obstetrics |
| url | http://www.sciencedirect.com/science/article/pii/S1930043320302521 |
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