A broad variety of abnormalities with widely variable prognosis can be seen in the chest and abdomen by prenatal imaging. Early and accurate diagnosis is important to appropriately counsel, plan management and improve outcomes. Ultrasound is the screening tool to first identify an abnormality. Magnetic resonance imaging has been shown to be a valuable adjuvant study. MRI description of the different entities affecting the chest and the abdomen as well as prognosis and fetal management options arediscussed.

Several advantages are seen when using MRI in the assessment of anomalies compared to ultrasound, including its multiplanar capability, large field of view, and soft tissue contrast between bowel, liver, normal lung and lung masses. The large field of view allows improved visualization of the lesions, useful for families and specialists to review and understand. In the setting of oligohydramnios and maternal obesity, MRI can delineate structures when US is unable to. MRI is not operator dependent, a vulnerability of ultrasound.

Improvements in ultrafast sequences help reduce motion artifact and have diminished the need for sedation.

A wide variety of congenital anomalies affect the thoracic and abdominal regions of the fetus. They can be small and asymptomatic or large and cause mass effect, with outcomes that vary significantly depending on associated anomalies and presence of complications such as lung hypoplasia and hydrops. These complications are of significant importance in the prognosis of the fetus.

Third trimester MR can help plan for postnatal care obviating the need for additional postnatal imaging which could require radiation and/or sedation.