Wise Rachel,  Belchos Jessica,  Gray Brian,  Timsina Lava,  Brown Brandon

Final Pr. ID: Poster #: SCI-011

Frequently diagnosed on prenatal imaging, including fetal MRI, omphalocele has highly variable morbidity and mortality. Few prenatal prognostic indicators have been previously identified. We propose that features found on fetal MRI can predict morbidity and mortality in patients diagnosed with omphalocele. Read More

Authors:  Wise Rachel , Belchos Jessica , Gray Brian , Timsina Lava , Brown Brandon

Keywords:  Omphalocele, Fetal MRI, Prognostication

Maddocks Alexis,  Ayyala Rama,  Jimenez Jesus,  Miller Russell,  Duron Vincent

Final Pr. ID: Poster #: SCI-006

Giant omphaloceles are large in size and contain a significant portion of liver. Giant omphaloceles are often associated with other co-morbidities, such as pulmonary hypoplasia, which can lead to respiratory insufficiency, prolonged intensive care support, assisted ventilation, and death. The purpose of this study is to develop a prognostic model for prediction of post-natal outcomes in patients with giant omphaloceles using fetal MRI calculated observed to expected total lung volumes (O/E TLV). Read More

Authors:  Maddocks Alexis , Ayyala Rama , Jimenez Jesus , Miller Russell , Duron Vincent

Keywords:  omphalocele, Fetal MR

Myers Ross,  Borer Joseph,  Estroff Judy,  Barnewolt Carol

Final Pr. ID: Paper #: 108

Bladder exstrophy (BE), cloacal exstrophy (CE), and "Omphalocele, Exstrophy of the Cloaca, Imperforate Anus, and Spinal Defects Complex" (OEIS) are very rare conditions. They can present in isolation or as part of a spectrum of congenital malformations involving multiple organ systems. The diagnosis can be missed or misidentified during prenatal imaging due in no small part to the rarity and complexity of these conditions. The purpose of this study is to determine whether prenatal referral to specialty centers improves diagnostic accuracy, with the potential to improve patient counseling through a multidisciplinary approach. Read More

Authors:  Myers Ross , Borer Joseph , Estroff Judy , Barnewolt Carol

Keywords:  OEIS, Exstrophy, Omphalocele

Cassella Katharyn,  Brown Brandon

Final Pr. ID: Poster #: EDU-016

With the increasing utilization of imaging in prenatal diagnosis, the fetal MR appearance of omphalocele has been well-described. However, as fetal MR plays a critical role not only for diagnosis but also for planning and family counseling, the radiologist is required to risk stratify the range of presentations of this anomaly. There is a broad spectrum of severity within this single diagnosis: ranging from a small and covered bowel-only defect, to a large and ruptured multi-organ hernia, to a complex omphalocele within a nonkaryotype fetal syndrome. Outcomes are highly variable, ranging from a simple hernia repaired with primary closure, to a protracted postnatal course with staged surgical repairs, to expected intrapartum demise. Further, neonatal pulmonary hypoplasia and hypertension often complicate more severe cases. Thus, accurate prognostication is essential to properly equip and prepare families, and thereby add value to perinatal care.

In this presentation, we outline a 7-point, systematic method for analyzing the varied presentations of omphalocele, as seen on both 1.5T and 3T MR field strengths. The approach we describe details the following diagnostic criteria: (1) the size of the defect, (2) type and volume of herniated organ contents, (3) presence/absence of an intact membrane, (4) presence/absence of hernia sac ascites, (5) associated pulmonary hypoplasia, (6) insertion of the umbilical cord, and (7) presence of irregular cord vessels. Finally, we demonstrate how this diagnosis can correlate with associated ischemic changes in the placenta, a finding which can further aid delivery planning and prognostication.
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Authors:  Cassella Katharyn , Brown Brandon

Keywords:  Omphalocele, Ventral hernia, Abdominoscisis