SPR 2019 Fetal Course SAM Session - Session 7

Friday, September 13th

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* 1. Which of the following is a correct statement regarding meconium in the rectum and colon on MR?

Hyperintense T1 meconium should be identified in the rectum by 20 weeks, extending at least 1cm below the bladder neck.

Hyperintense T1 meconium should be identified in the rectum by 25 weeks, extending at least 1cm below the bladder neck.

Hyperintense T1 meconium should be identified in the rectum by 20 weeks, extending at least 2 cm below the bladder neck.

Hyperintense T1 meconium should be identified in the rectum by 25 weeks, extending at least 2 cm below the bladder neck.

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* 2. Which is true regarding small bowel appearance on fetal MRI?

The appearance of the jejunum and ileum are readily distinguishable on fetal MR imaging.

In the early second trimester, the small bowel is typically fluid filled throughout.

Prior to 32 weeks gestation, residual meconium may be seen within the distal ileum.

The small bowel loops are typically collapsed containing only minimal fluid in the late third trimester.

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* 3. All of the following is true of meconium, EXCEPT:

In cystic fibrosis, the tenacious meconium is T1 hypointense throughout

Meconium is produced by liver and intestinal glands in the 1st trimester and migrates from the small bowel to the rectum with increasing gestational age

Meconium demonstrates T1 hyperintense signal due to high protein and paramagnetic substances such as copper, iron, and manganese

The distribution of fetal meconium can aid in localization of GI tract obstruction

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* 4. In the diagnosis of esophageal atresia, MR imaging findings may include which of the following?

Non-visualized fetal stomach

Small/contracted fetal stomach

Normal fetal stomach

All of the above

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* 5. Second trimester fetal MRI demonstrating a microcolon appearance is typically seen in which of the following?

Duodenal atresia

Distal small bowel obstruction, such as ileal atresia and meconium ileus

Colonic obstruction, such as meconium plug syndrome and Hirschsprung disease

B and C

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* 6. Absent T1 hyperintense signal in the colon, together with fluid-dilated small bowel, and fluid filled colon and rectum should raise suspicion for what diagnosis?

Ileal atresia

Meconium ileus

Congenital diarrhea

Anal atresia with urorectal fistula

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* 7. Which of the following is the most commonly encountered mass or cyst in the fetal abdomen?

Ovarian cyst

Hepatic cyst

Ovarian teratoma

Hepatic hemangioma

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* 8. Which is true regarding most prenatally detected hepatic hemangiomas?

They tend to be solitary rather than multifocal.

They are highly associated with perinatal hypothyroidism.

They grow after birth.

They are GLUT-1 positive.

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* 9. Which cyst should be resected for risk of malignant degeneration?

Hepatic

Choledochal

Pancreatic

Splenic

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* 10. What ventral wall defect is primarily linked to Beckwith-Wiedemann syndrome?

Gastroschisis

Omphalocele

Bladder exstrophy

Limb body wall complex

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* 11. The heart is ectopic in which of these abdominal wall defects?

Umbilical cord hernia

Omphalocele

Bladder exstrophy

Pentalogy of Cantrell

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