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Integrating 3D Sonography With Targeted MRI in the Prenatal Diagnosis of Posterior Cleft Palate Plus Cleft Lip

Division of Obstetrics & Gynecology, Guastalla Civil Hospital, Via Donatori di Sangue, 42016 Guastalla (RE), AUSL Reggio Emilia, Italy. Gabriele.Tonni{at}asul.re.it

Marco Panteghini, MD

Division of Obstetrics & Gynecology, Guastalla Civil Hospital, AUSL Reggio Emilia, Italy

Pierpaolo Pattacini, MD

Division of Radiology, Guastalla Civil Hospital, AUSL Reggio Emilia, Italy

Claudio De Felice, MD

Department of Neonatology, Policlinic Hospital "Le Scotte," University of Siena, Italy

Giovanni Centini, MD

Department of Obstetrics & Gynecology, Policlinic Hospital "Le Scotte," University of Siena, Italy

Alessandro Ventura, MD

Division of Obstetrics & Gynecology, Guastalla Civil Hospital, AUSL Reggio Emilia, Italy

Cleft lip and cleft palate are among the more common congenital abnormalities, present in 1.82 per 1000 live births. Although high-quality antenatal 2D sonography can diagnose clefts of the lips and the alveolar ridge, 3D may enhance detection by examining the fetal face in the frontal plane followed by a secondary rotation through 180 degrees on the vertical axis to examine the secondary palate, which has been called the "reverse face" view. Sonographically 3D targeted ultrafast magnetic resonance imaging (MRI) has been shown to improve the diagnostic accuracy of facial cleft by identifying whether a cleft in the primary palate extends to the secondary palate. Further investigation may confirm the ability of MRI to define the extent of the cleft to the secondary palate at a less advanced gestational age (18-23 weeks), where either fetal development or movements could reduce the accuracy of the technique.

Key Words: cleft lip • cleft palate • 3D sonography • magnetic resonance imaging

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