Introduction Advances in technology have allowed vast improve- ments to be made in the diagnosis and therapy of fetal anomalies. Nowhere is this more currently applicable than in the fetal spine. US remains the primary imaging modality for evaluating the developing fetus and can distinguish normal from abnormal spine development, and provide valuable information about spinal anoma- lies. MRI of the fetal spine is complementary, in fact often superior, to US for assessment of suspected spinal malformations, and has the advantage of better detec- tion of associated CNS and non-CNS anomalies, which may significantly impact postnatal neurological function and quality of life [1, 2]. An additional driving force in the need for highly detailed prenatal imaging is the rapidly expanding field of in utero surgery, particularly myelomeningocoele (MMC) repair. The US information, consisting of osseous detail and real-time evaluation of lower extremity configuration, position and motion, com- bined with the soft tissue and parenchymal assessment of MRI, provides the maternal–fetal medicine special- ist and paediatric neurosurgeon with detailed ana- tomical information. As the surgery has risk to the mother and the fetus, obtaining extremely accurate, detailed anatomical information is essential for deter- mining who is an appropriate candidate for prenatal intervention, and it also provides important surgical planning data. For those fetuses in whom significant congenital anomalies are present outside of the CNS, information about associated spinal abnormalities may be of value in counselling parents so that they can make well-informed decisions regarding the management of the pregnancy and of the labour and delivery, or the continuation of the pregnancy itself. Technique Fetal MRI is best performed on a high-performance, 1.5-T superconducting magnet. A surface coil, generally a dedicated four-element torso or body phased-array Erin M. Simon MRI of the fetal spine Received: 15 March 2004 Accepted: 5 April 2004 Published online: 28 July 2004 Ó Springer-Verlag 2004 Abstract Magnetic resonance imag- ing of the fetal spine is a vital com- plement to fetal sonographic examination. Assessing the wide spectrum of spinal dysraphism, as well as spinal neoplasia, allows for more correct prenatal diagnoses, patient care planning, and patient counselling. Proper appraisal of the value of experimental procedures, such as fetal myelomeningocoele re- pair, requires a high level of diag- nostic accuracy for the selection and follow-up of appropriate candidates. Keywords Fetus Æ Spine Æ Congeni- tal Æ Technique Æ MRI Pediatr Radiol (2004) 34: 712–719 DOI 10.1007/s00247-004-1245-1 MINISYMPOSIUM E. M. Simon Departement of Radiology, The Children’s Hospital of Philadelphia, and Neuroradi- ology Suite, Wood Center, 2nd Floor, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104-4399, USA E-mail: simon@email.chop.edu Tel.: +1-215-5909048 Fax: +1-215-5901345