Detecting Fetal Central Nervous System Anomalies Using Magnetic Resonance Imaging and Ultrasound

Abstract

Background: Most fetal abnormalities can be detected on ultrasound, the evaluation of fetal CNS abnormalities can be limited by various factors, including obesity, polyhydramnios, multiple pregnancies, and increased cranial ossification during the third trimester. Objective: This study aimed to evaluate the ability to detect fetal central nervous system (CNS) anomalies using in utero magnetic resonance imaging (iuMRI) and ultrasound (US) techniques. Methods: This prospective study was approved by the institutional review board (Ref: 2968/QĐ-ĐHYHN dated 11 July 2019), and the requirement to obtain the informed consent of patients was waived. This study included 66 fetuses with diagnosed or suspected CNS abnormalities based on the results of a prenatal screening US performed at the antenatal diagnosis center of the Central Obstetrics and Gynecology Hospital. All pregnant women with a suspected diagnosis of abnormal fetal CNS on US underwent 1.5-Tesla iuMRI within 14 days of the US at Hanoi Medical University Hospital between June 2019 and June 2020. Cohen’s kappa coefficient (κ) was used to determine the agreement between US and iuMRI findings. Results: A total of 66 pregnant women were examined, including 66 fetuses, for which 79 abnormalities were detected by US and 98 abnormalities were detected by iuMRI. The average gestational age was 29 weeks and 6 days. The comparison of iuMRI and US findings revealed similar diagnoses for 71 abnormalities (67%) and different diagnoses for 35 abnormalities (33%). The level of agreement between US and iuMRI was almost perfect for ventriculomegaly and cystic lesions, with κ values 0.87 and 0.84, respectively. The level of agreement between US and iuMRI was the weakest for hemorrhage, with a κ value 0 (no agreement), and cortical abnormalities, with a κ value of 0.46 (weak agreement). Conclusion: The level of agreement between US and iuMRI diagnoses was almost perfect for the detection of ventriculomegaly and was weakest for the detection of hemorrhage and cortical abnormalities, which were abnormalities detected by iuMRI but not by ultrasound.

The role of routine first-trimester ultrasound screening for central nervous system abnormalities: a longitudinal single-center study using an unselected cohort with 3-year experience

“…However, in some of these cases, ultrasound revealed the abnormal middle cerebral artery blood flow or small biparietal diameter and head circumference. This demonstrated that MRI could be an adjunct, which were able to detect additional lesions that were either suspected or missed on US, including destructive lesions, cortical abnormalities, corpus callosum anomalies, and posterior fossa anomalies, as previous studies have shown [ 25 – 27 ]. Therefore, MRI should be recommended in fetuses suspected of having CNS abnormalities on ultrasonography.…”

Evaluation of Congenital Cytomegalovirus Infection in Pregnant Women Admitted to a University Hospital in Istanbul

“…Observations such as ventriculomegaly, cortical malformations, calcifications, hepatosplenomegaly, liver signal alterations, and abnormal effusions are not exclusive to congenital CMV infection. FMR is also important for revealing cerebral abnormalities like polymicrogyria, lissencephaly, etc., which cannot be seen using ultrasound examination [ 51 , 52 ].…”