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1848772 
Journal Article 
Fetal MRI of cloacal exstrophy 
Calvo-Garcia, MA; Kline-Fath, BM; Rubio, EI; Merrow, AC; Guimaraes, CV; Lim, FY 
2013 
1 
Pediatric Radiology
ISSN: 0301-0449
EISSN: 1432-1998 
43 
5 
593-604 
English 
23184094 
WOS:000317665700012 
BACKGROUND: Prenatal ultrasonographic (US) diagnosis of cloacal exstrophy (CE) is challenging.

OBJECTIVE: To define the fetal MRI findings in CE.

MATERIALS AND METHODS: We performed a retrospective review of eight patients with CE. Imaging was performed between 22 weeks and 36 weeks of gestation with US in four and MRI in eight fetuses. Abdominal wall, gastrointestinal/genitourinary, and spine and limb abnormalities detected were compared with postnatal evaluation.

RESULTS: US failed to display CE in one of the four fetuses. Fetal MRI confirmed CE in all eight fetuses by demonstrating absence of a normal bladder and lack of meconium-filled rectum/colon, associated with protuberant pelvic contour and omphalocele. These findings correlated postnatally with CE, atretic hindgut and omphalocele. One fetus had imaging before rupture of the cloacal membrane, showing a protruding pelvic cyst. Absent bladder was noted in the remaining seven fetuses. Confirmed skin-covered spinal defects were noted in seven fetuses, low conus/tethered cord in one and clubfoot in three. Six fetuses had renal anomalies, two had hydrocolpos and one had ambiguous genitalia.

CONCLUSION: Fetal MRI provides a confident diagnosis of CE when a normal bladder is not identified, there is a protuberant abdominopelvic contour and there is absence of meconium-filled rectum and colon. Genitourinary and spinal malformations are common associations. 
Cloacal exstrophy; OEIS; Prenatal diagnosis; Fetal MRI; Anorectal malformation