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. 2026 Jan 25;15(1):20584601261419037.
doi: 10.1177/20584601261419037. eCollection 2026 Jan.

3D steady-state free precession in fetal body MR imaging: A useful adjunctive sequence

Affiliations

3D steady-state free precession in fetal body MR imaging: A useful adjunctive sequence

Kantheera Leesmidt et al. Acta Radiol Open. .

Abstract

Fetal magnetic resonance imaging (MRI) has become a valuable noninvasive method for evaluating congenital anomalies of the fetus and can serve as an important adjunct to the prenatal ultrasound, particularly where the ultrasound is unable to exclude or detect fetal abnormalities. This pictorial review will describe the utilization of three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) in various clinical entities, specifically at 3T, and how to generate clinically valuable information.

Keywords: 3D steady-state free precession; 3D-FIESTA; fetal MR imaging; fetus; pediatrics; prenatal diagnosis; subject matter; topics.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Sagittal (a, b) and coronal (c) 3D-FIESTA on 3T MRI showing a fetus with congenital high airway obstruction sequence (CHAOS). The fetus has dilated airway (black arrow), markedly enlarged lung volumes with increased signal (L), inverted diaphragms (white arrow), and marked ascites (A).
Figure 2.
Figure 2.
Coronal 3D-FIESTA on 3T MRI showing a 23-week fetus with hydrops fetalis and right pleural effusion (arrow), causing right lung collapse (L) and mediastinal shift. Fetal intervention was considered in this case and thoracic drain placement was performed.
Figure 3.
Figure 3.
Axial (a, b) and sagittal (c, d) 3D-FIESTA on 3T MRI showing a fetus with hepatic cystic mass (M), demonstrating claw sign (white arrows) of the liver (L). Note that the hepatic cyst shows an internal septation (black arrows).
Figure 4.
Figure 4.
(a) Sagittal single-shot T2-weighted (SST2W) image showing hydrometrocolpos (arrows) with a good resolution image. (b and c) Sagittal 3D-FIESTA images at 3T showing hydrometrocolpos (arrows) with motion artifacts. (d) Prenatal ultrasonography showing hydrometrocolpos. BL = urinary bladder. Vg = vagina. Ut = uterus.
Figure 5.
Figure 5.
Curved planar 3D-FIESTA on 3T MRI showing a fetus with right hydronephrosis, hydroureter, and ureterocele (arrow). RK = right kidney.
Figure 6.
Figure 6.
(a) 3D-FIESTA on 3T MRI showing a fetus with a clubfoot (arrow). (b) 3D-FIESTA on 3T MRI showing a screenshot of a surface rendered model which can also subsequently be used in augmented or virtual reality displays or 3D printed.
Figure 7.
Figure 7.
Coronal 3D-FIESTA on 3T MRI showing conjoined twins along with banding artifacts (dotted arrows), which occasionally degrades the 3T fetal MRI. Of note, the fetal airway is well seen (solid arrow).
Figure 8.
Figure 8.
Multiplanar 3D-FIESTA on 3T MRI showing a fetus with a large solid-cystic mass of teratoma (M) arising from the neck. This sequence demonstrates a distinct lesion with superior tissue characterization.
Figure 9.
Figure 9.
3D-FIESTA on 3T MRI showing a fetus with cleft lip.
Figure 10.
Figure 10.
Sagittal 3D-FIESTA on 3T MRI showing a tortuous, distended, tubular, fluid-filled structure in the posterior mediastinum (arrows). This structure shows peristalsis on ultrasound. No feeding vessel was identified. Esophageal duplication cyst was the primary consideration.
Figure 11.
Figure 11.
3D-FIESTA on 3T MRI demonstrating 3D rendered model of an esophageal duplication cyst.
Figure 12.
Figure 12.
3D-FIESTA on 3T MRI demonstrating a surface rendered model of the placenta.

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