Magnetic Resonance Imaging for Detection of Brain Abnormalities in Fetuses With Cleft Lip and/or Cleft Palate

Objective: To determine the prevalence of brain abnormalities identified by prenatal imaging of fetuses with cleft lip with or without cleft palate (CL/P) or cleft palate only (CP) and to compare with postnatal imaging and neurologic evaluation. Design: This was a retrospective review of radiologic images (magnetic resonance imaging [MRI] and sonography) of fetuses diagnosed with CL/P or CP at the Advanced Fetal Care Center at Children's Hospital Boston between 2002 and 2008. Images were reviewed for possible brain abnormalities by a pediatric radiologist who specializes in this field. Postnatal imaging was also assessed whenever available and correlated with clinical findings. Setting: A large, tertiary-care, academic pediatric hospital. Population: One hundred twenty-six fetuses and 105 corresponding infants. Results: Brain abnormalities were found in 8 of 126 fetuses (6.3%) by prenatal MRI. The malformations were corpus callosal dysgenesis (n = 3), encephalocele (n = 1), hypoplasia of the cerebellar hemispheres or vermis (n = 3), and white matter neuronal migration anomaly (n = 1). An additional 2 patients were diagnosed with brain abnormalities postnatally that had not been detected on prenatal imaging. Conclusions: The possibility of brain anomalies should be assessed in a fetus found to have CL/P or CP by sonography and/or MRI. Central nervous system imaging and careful neurodevelopmental follow-up is indicated in these infants.