Imaging of Fetal Orbits

Abstract

Abnormalities of the fetal orbit are occasionally visualized in the workup of suspected central nervous system malformation. It may be difficult to recognize orbital pathology in fetuses, especially when it is bilateral and symmetric. In this article, we at first addressed a normal appearance of the fetal orbits on prenatal imaging, which includes obstetric ultrasound and fetal magnetic resonance imaging. We also described a spectrum of lesions involving fetal eyes and orbits, including abnormal fetal orbital biometry, abnormal morphology of the vitreous and lens, and neoplastic and nonneoplastic masses of the orbits. Fetal orbital anomalies may be associated with a long list of underlying systemic disorders. For that reason, sometimes a particular orbital anomaly may be helpful as a denominator to narrow a diagnosis. Detection of fetal orbital lesions should prompt a diligent search for associated birth defects arising at the same time or sharing the same progenitor cell.

Keywords

fetal orbits - biometry - coloboma - cataract - microphthalmia - MRI - US

• References

• 1 ACR–ACOG–AIUM–SRU practice parameter for the performance of obstetrical ultrasound 2014. Available at: http://www.acr.org/~/media/f7bc35bd59264e7cbe648f6d1bb8b8e2.pdf . Accessed February 10, 2015
• 2 ACR–SPR practice parameter for the safe and optimal performance of fetal magnetic resonance imaging (MRI) 2014 [cited 2015 February 10]. Available at: http://www.acr.org/~/media/CB384A65345F402083639E6756CE513F.pdf . Accessed February 10, 2015
• 3 Birnholz JC, Farrell EE. Fetal hyaloid artery: timing of regression with US. Radiology 1988; 166 (3) 781-783
• 4 Katorza E, Rosner M, Zalel Y, Gilboa Y, Achiron R. Prenatal ultrasonographic diagnosis of persistent hyperplastic primary vitreous. Ultrasound Obstet Gynecol 2008; 32 (2) 226-228
• 5 Mayden KL, Tortora M, Berkowitz RL, Bracken M, Hobbins JC. Orbital diameters: a new parameter for prenatal diagnosis and dating. Am J Obstet Gynecol 1982; 144 (3) 289-297
• 6 de Elejalde MM, Elejalde BR. Ultrasonographic visualization of the fetal eye. J Craniofac Genet Dev Biol 1985; 5 (4) 319-326
• 7 Trout T, Budorick NE, Pretorius DH, McGahan JP. Significance of orbital measurements in the fetus. J Ultrasound Med 1994; 13 (12) 937-943
• 8 Robinson AJ, Blaser S, Toi A , et al. MRI of the fetal eyes: morphologic and biometric assessment for abnormal development with ultrasonographic and clinicopathologic correlation. Pediatr Radiol 2008; 38 (9) 971-981
• 9 Paquette LB, Jackson HA, Tavaré CJ, Miller DA, Panigrahy A. In utero eye development documented by fetal MR imaging. AJNR Am J Neuroradiol 2009; 30 (9) 1787-1791
• 10 Pilu G, Segata M, Perolo A. Ultrasound of the fetal face and neck. In: Callen P, ed. Ultrasonography in Obstetrics and Gynecology. 5th ed. Philadelphia: Saunders; 2007: 392-418
• 11 Bardakjian T, Weiss A, Schneider A . Anophthalmia/Microphthalmia Overview 2006. Available at: http://www.ncbi.nlm.nih.gov/books/NBK1378/ . February 10, 2015
• 12 Levine D, Barnes PD, Madsen JR, Li W, Edelman RR. Fetal central nervous system anomalies: MR imaging augments sonographic diagnosis. Radiology 1997; 204 (3) 635-642
• 13 Poutamo J, Vanninen R, Partanen K, , Ryynänen, Kirkinen P. Magnetic resonance imaging supplements ultrasonographic imaging of the posterior fossa, pharynx and neck in malformed fetuses. Ultrasound Obstet Gynecol 1999; 13 (5) 327-334
• 14 Dutton GN. Congenital disorders of the optic nerve: excavations and hypoplasia. Eye (Lond) 2004; 18 (11) 1038-1048
• 15 Righini A, Avagliano L, Doneda C , et al. Prenatal magnetic resonance imaging of optic nerve head coloboma. Prenat Diagn 2008; 28 (3) 242-246
• 16 Zimmer EZ, Bronshtein M, Ophir E , et al. Sonographic diagnosis of fetal congenital cataracts. Prenat Diagn 1993; 13 (6) 503-511
• 17 Paquette LB, Miller D, Jackson HA , et al. In utero detection of retinoblastoma with fetal magnetic resonance and ultrasound: initial experience. AJP Rep 2012; 2 (1) 55-62
• 18 Robson CD, Barnewolt CE. MR imaging of fetal head and neck anomalies. Neuroimaging Clin N Am 2004; 14 (2) 273-291 , viii
• 19 Mirsky DM, Shekdar KV, Bilaniuk LT. Fetal MRI: head and neck. Magn Reson Imaging Clin N Am 2012; 20 (3) 605-618
• 20 Davis WK, Mahony BS, Carroll BA, Bowie JD. Antenatal sonographic detection of benign dacrocystoceles (lacrimal duct cysts). J Ultrasound Med 1987; 6 (8) 461-465
• 21 Goldberg H, Sebire NJ, Holwell D, Hill S. Prenatal diagnosis of bilateral dacrocystoceles. Ultrasound Obstet Gynecol 2000; 15 (5) 448-449
• 22 Yazici Z, Kline-Fath BM, Yazici B, Rubio EI, Calvo-Garcia MA, Linam LE. Congenital dacryocystocele: prenatal MRI findings. Pediatr Radiol 2010; 40 (12) 1868-1873
• 23 Hergan B, Atar OD, Poretti A, Huisman TA. Serial fetal MRI for the diagnosis of Aicardi syndrome. Neuroradiol J 2013; 26 (4) 380-384
• 24 Pagon RA, Graham Jr JM, Zonana J, Yong SL. Coloboma, congenital heart disease, and choanal atresia with multiple anomalies: CHARGE association. J Pediatr 1981; 99 (2) 223-227
• 25 Tilea B, Garel C, Menez F , et al. Contribution of fetal MRI to the diagnosis of inner ear abnormalities: report of two cases. Pediatr Radiol 2006; 36 (2) 149-154
• 26 Reed UC. Congenital muscular dystrophy. Part I: a review of phenotypical and diagnostic aspects. Arq Neuropsiquiatr 2009; 67 (1) 144-168
• 27 Strigini F, Valleriani A, Cecchi M , et al. Prenatal ultrasound and magnetic resonance imaging features in a fetus with Walker-Warburg syndrome. Ultrasound Obstet Gynecol 2009; 33 (3) 363-365
• 28 Tasse C, Böhringer S, Fischer S , et al. Oculo-auriculo-vertebral spectrum (OAVS): clinical evaluation and severity scoring of 53 patients and proposal for a new classification. Eur J Med Genet 2005; 48 (4) 397-411
• 29 Moog U, Jones MC, Bird LM, Dobyns WB. Oculocerebrocutaneous syndrome: the brain malformation defines a core phenotype. J Med Genet 2005; 42 (12) 913-921