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This is another example of a

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multigestation pregnancy on MRI.

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We have axial T2-weighted images of the

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abdomen and pelvis, and as we see the

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gravid uterus begin to come into view,

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we see one fetus located superiorly

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and a second fetus located inferiorly.

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So we see this fetal cranium

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as well as this fetal cranium.

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They share a little bit of space

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up near the fundus of the uterus.

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Posteriorly located for this

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patient is the placenta.

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And again, we see T2 heterogeneous

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myometrium surrounding the amniotic sac.

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It can sometimes be difficult to visualize

0:44

the separation between amniotic sacs on

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MRI, particularly because there can be some

0:50

artifacts or the slice thickness may not

0:52

permit visualization of the amniotic sac.

0:56

What is important to point out for

0:57

this pregnancy is that there is a

0:59

single posteriorly located placenta.

1:02

So, this is a monochorionic twin pregnancy.

1:06

On the sagittal, again, we see that

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single, although quite large, placenta,

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and two cephalic presentation fetuses.

1:15

Again, we see the cervical canal, and we

1:17

can verify that the internal os is closed.

1:20

What I'd like to point out is you may

1:22

see this artifact throughout the amniotic

1:25

fluid, this sort of swirling appearance,

1:28

again, that's motion artifact from the

1:30

circulation of the amniotic fluid, which

1:33

we can see and which is important for

1:35

dissipating heat in the context of MRI.

1:38

We can also see a focal bulge along the

1:41

anterior aspect of the uterus for this patient.

1:43

This is a focal myometrial contraction, and the

1:46

way that you can verify that is often later

1:49

in the exam, these findings will resolve.

1:52

This is a coronal T2-weighted image of the

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abdomen and pelvis in the same patient.

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And we really get a beautiful

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look at that very dramatic fluid

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circulation artifact for this patient.

2:03

Again, we see the first fetus and the

2:07

second fetus and a single fundal placenta.