Purpose or Case Report: To provide MRI staff education on MRI fetal exams for sacrococcygeal teratomas. Sacrococcygeal teratoma (SCT) is a congenital germ cell tumor located at the base of the tailbone in newborns. This birth defect is generally not malignant. A SCT is most often diagnosed prenatally using routine obstetric ultrasonography, and further anatomical evaluation may require MRI. A SCT can grow during pregnancy and develop large blood vessels requiring more work for the fetal heart. SCT are more common in females than in males and occur in about 1 in 35,000 live births.
Methods & Materials: Ann & Robert H. Lurie Children’s Hospital of Chicago scanned approximately 100 fetal MRI exams in fiscal year 2016. Lurie Children’s new Chicago Institute of Fetal Health program has increased the volume of fetal cases being performed in our MR department. Now with more cases being scanned we are seeing more rare pathology and diagnosis than prior. One of the recent cases was diagnosed as a fetal sacrococcygeal teratoma. Evaluation of this case has led to a modification of our fetal scanning protocol to accommodate previously identified SCT.
Results: MR staff will need to identify and properly scan sacrococcygeal teratomas that may be indicated amongst our fetal cases. Sacrococcygeal teratoma requires the technologist to identify the pathology and extend the scan field of view to include the extent of the tumor. Patient position may need to be modified to optimize the image quality. Radiologist surveillance at the scanner may assist in ensuring images are of sufficient diagnostic quality.
Conclusions:
Fetal sacrococcygeal teratoma are rare but the imaging performed in MRI may yield helpful results to prepare for the next steps if the MRI protocol is adjusted appropriately.