[Magnetic resonance imaging in the differential diagnosis of fetal abdominopelvic cysts: a retrospective case series].

Authors

Evelin Laura Simon, Anett Szalkó, Balázs Gadóczi, Andrea Lakatos

Published in

Orvosi hetilap. Volume 167. Issue 39. Pages 1565-1573. Sep 27, 2026. Epub Sep 27, 2026.

Abstract

Abdominopelvic cystic lesions are relatively common findings during pregnancy. Ultrasound examinations performed during pregnancy can easily identify these cysts; however, accurate characterization is not always possible using ultrasound alone. The introduction of rapid magnetic resonance (MR) sequences allows more precise characterization of these lesions and also assists in therapeutic decision-making.
To identify fetal abdominopelvic cysts and assess their characteristics, ranging from the most common presentations to less frequently occurring cases.
In this retrospective study, we evaluated pregnant women whose fetuses were found to have cystic lesions detected during prenatal ultrasound examinations.
Between 1 February 2017 and 15 October 2024, 12 fetal MR examinations were performed due to suspected fetal abdominopelvic cystic lesions. In our cases, the underlying causes of the cysts included sacrococcygeal teratoma, unilateral or bilateral ovarian cysts, lymphatic malformation, liver cyst, and other developmental anomalies (urovesical obstruction with consequent hydronephrosis, right renal agenesis with a cystic left kidney, and subvesical obstruction with bilateral hydronephrosis). In the case of sacrococcygeal teratoma, MR examination enabled preoperative planning. Several cystic lesions showed spontaneous regression during observation. Urovesical obstruction was managed with percutaneous nephrostomy, while subvesical obstruction was treated with vesicostomy. In one case, termination of pregnancy was performed.
Abdominopelvic cysts represent a wide spectrum of conditions, and their characterization may be supported by the fetal sex, gestational age, and anatomical location. The most common sites of origin include the ovaries, gastrointestinal tract, liver, mesentery, and urinary tract. Less common entities include pancreatic cysts, cystic teratomas, and hepatoblastomas. Prenatal ultrasound remains the primary imaging modality for screening cystic lesions; however, MR examination plays an important complementary role in the detailed evaluation of morphological features and in the differential diagnosis of these lesions. In particular, the use of ultrafast MR sequences allows more accurate tissue characterization and more detailed assessment of anatomical relationships, thereby facilitating therapeutic decision-making, especially in complex cases or those requiring surgical intervention.
Ultrasound examination during pregnancy is effective in detecting cystic lesions; however, precise localization, characterization, and differential diagnosis may be limited. Fetal MR examination provides an opportunity for more detailed anatomical localization, morphological evaluation, and tissue characterization of these lesions, thereby supporting therapeutic decision-making, potential pre- and postnatal surgical planning, and the establishment of appropriate follow-up strategies. Orv Hetil. 2026; 167(39): 1565-1573.

PMID:
42801467
Bibliographic data and abstract were imported from PubMed on 28 Sep 2026.

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