Section outline

  • Dr. Dorothy Bulas  Dr. Dorothy Bulas

    Welcome to Fetal Imaging.

    Pediatric Radiology includes the exciting field of “Fetology”.  Imaging of the fetus is fascinating in many ways, helping us understand the pathophysiology of numerous abnormalities, as well as the normal growth and development of the fetus.  As a fetal imager, one works with numerous subspecialties to help determine appropriate perinatal care, and postnatal management.  Counseling of families is a moving experience, with multiple medical and ethical issues to consider. Much research still needs to be done with advances in fetal imaging – Doppler, 3D/4D, MR spectroscopy, DWI/EPI helping advance fetal intervention. 

    Ultrasound is the modality of choice when imaging the pregnancy and fetus.  It is noninvasive, safe due to absence of radiation, low in cost and has widespread availability.  The technique has high accuracy and superior spatial resolution, allowing real time, color Doppler, multiplanar and 3-4 dimensional capabilities.

    When an abnormality on US is not clearly defined and more information is sought in order to decide about therapy, delivery, or to advise a family about prognosis MR can be performed. MR can improve the assessment of a potential anomaly particularly in the setting of maternal obesity or oligohydramnios. Fetal MR is particularly powerful in the evaluation of the fetal brain and can help asses lung volumes in cases of congenital diaphragmatic hernia or lung masses.

    Fetal Imaging Rotation Tips:

    • Fetal cases are scheduled Tuesday through Friday. 

    • MR cases start at 7 AM with US to follow through the early afternoon.

    • Have the fetal center send you the case list the day prior to review the histories and read up on the diagnosis.

    • Notify the fetal attending each day you are on fetal so they expect you, know where to locate you and can start reviewing  cases with you  in real time if appropriate.

    • Atleast a few times during your rotation, skip a 7 30 didactic conference and go sit with the MR techs and watch fetal MR scans being performed.

    • Atleast a few times during your rotation, sit with the sonographer and watch an OB US completed – learn how to accurately measure HC/BPD/FL/AC.

    • Discuss with the attending which fetal MR and OB US cases to dictate – templates available

    • Atleast a few times, arrange with the fetal neuroradiologist to review fetal MR neuro cases  together. Ask if you can dictate a neuro case.

    • Participate in the daily 11 AM case review

    • Take advantage of the Prenatal Pediatric Institute which is a consortium of subspecialists throughout the hospital with a particular interest in fetal care. Weekly meetings and numerous CME lectures are offered throughout the month.

      • Attend Weekly Fetal Meeting - Tuesday from 7 – 8 AM

      • Attend CME lectures – usually from 12-1   Mondays and Tuesdays monthly

      • PPI Ethics Rounds

    • Hundreds of fetal cases can be reviewed under Synapse  All users/bulas,dorothy/fetal…..


    Fetal competencies

      • Participate fully on service 

      • Watch Fetal MR techs scan

      • Watch OB sonographers scan

      • Review fetal case histories the night before

      • Read about the diagnosis to be imaged the night before – pull articles or read the appropriate chapter in Fundamental and Advanced Fetal Imaging

      • Review cases with the fetal body and fetal neuro attendings each day.

      • Learn normal fetal brain anatomy for each GA via the atlas in Fundamental and Advanced Fetal Imaging

      • Dictate select fetal body and neuro cases

      • Present a case each week in interesting case conference

      • Consider working on a poster or abstract on fetal imaging


    Recommended Reading:

    • Fundamental and Advanced Fetal Imaging: US and MRI   Kline-Fath, Bulas, Lee (2021) Wolters Kluwer

    • MRI of the Fetal Brain: Normal Development and Cerebral Pathologies. C Garel et al; Springer (2004).

    • Fetal MRI. D Prayer (ed.), Springer (2011)

    • Mini-symposium on Fetal MRI. Pediatric Radiology, volume 34(9): 681-719. (2004) http://www.springerlink.com/content/0301-0449/34/9/

    • Fetal magnetic resonance imaging: jumping from 1.5 to 3 tesla T Victoria et al Pediatr Radiol (2014) 44:376–386 DOI 10.1007/s00247-013-2857-0


    Web sites:


    Twitter: @fetal_imaging

    Instagram username – fetal_imaging

    Facebook - https://www.facebook.com/fetal.imaging