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Background
Urogenital and anorectal malformations are rare conditions related to abnormal embryological development. Fetal MRI is becoming more frequently used to further evaluate abnormalities seen on screening pregnancy ultrasound and may often reveal anatomic abnormalities not previously seen. Therefore, the radiologist is a vital player in detecting and accurately characterizing these embryologic abnormalities.

Educational Goals / Teaching Points
The primary goal is to review the perinatal imaging characteristics of urogenital and anorectal malformations on fetal MRI and second-look targeted ultrasonography with focus on persistent cloaca. In the process, we will provide a brief overview of normal embryology, evaluation of relevant normal fetal anatomy, and examples of the salient findings seen in the setting of persistent cloaca and anorectal malformations.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Persistent cloaca are anorectal malformations that are a result of failed embryogenesis resulting in a common excretory channel. These malformations are often associated with other anomalies, commonly gastrointestinal, renal, and spinal, which should be thoroughly examined in the setting of a cloaca. Treatment involves complex surgeries that vary depending on the degree of malformation. Familiarity of normal fetal imaging, relevant embryogenesis, and common findings of persistent cloaca will enable the radiologist to identify and accurately characterize persistent cloaca and similar malformations. We present multiple cases of persistent cloaca confirmed postnatally, along with their associated anomalies.

Conclusion
Persistent cloaca and other similar anomalies are rare conditions of incomplete embryologic development. As fetal MRI becomes more frequently performed, it is important that the radiologist is familiar with the salient findings that may suggest the diagnosis, especially in the setting of associated abnormalities.